Maxillofacial Surgery Peter Ward Booth

Ralph Kerr-Gilbert died (January 2013) after a short illness at the age of 93. He was one of the pioneers who established oral and maxillofacial surgery in district general hospitals. He worked for most of his consultant career as a single-handed surgeon, who created and established a thriving unit, delivering the highest standard of care. Ralph was a truly open and honest person, for whom patients, colleagues, trainees and staff at all levels had huge respect and fondness. He was a team player, whose work ethic seemed boundless, rarely taking holidays, managing trauma and large volumes of elective surgery. A full week's work was rounded off by a Saturday elective list and usually a Sunday trauma list.

Dr. Sanjiv.Nair graduated from the Trivandrum Medical College, Kerala in the year 1987. He completed his post graduate degree in Oral and maxillofacial surgery from the same institution in 2000, passing out with honours.

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He is presently professor and head of department, oral and maxillofacial surgery, Bangalore Institute of Dental Sciences. Consultant surgeon at Columbia Asia hospitals, B.M Jain Hospital, and Mallya hospital, Bangalore. He has served as Academic council member in the RGUHS in 2008-09.

Dr. Sanjiv Nair has served as the executive member of the International association of maxillofacial surgeons and was vice chairman of the 18th ICOMS; Bangalore. He has several international and national presentations and publications in Orofacial malignancies and Vascular lesions apart from contribution to the textbook of Maxillofacial surgery by Peter Ward Booth, Schendel and Hausemen.

There is recognition that the provision of excellence in education and training results in a skilled and competent workforce. However, the educational experiences of dental core trainees (DCT's) working in the hospital oral and maxillofacial surgery (OMFS) setting have not been previously investigated. In this paper, we examine DCT's learning experiences both 'formal' and 'non-formal' within the hospital setting of ward and clinic-based teaching. Are hospital dental core trainees receiving a meaningful educational experience? To conclude this paper, the authors recommend methods, based upon sound educational principles, to maximise the value of clinical sessions for teaching.

Academic medical centers, which have traditionally been relatively inefficient, have increasing difficulty in meeting the missions of patient care, teaching, and research in a progressively competitive medical marketplace. One strategy for improved efficiency in patient care while keeping quality high is utilization of a product line matrix. This study addresses the outcome of utilizing a product line strategy consisting of 3 service lines during the past 5 years at the University of Wisconsin Hospital and Clinics (UWHC). Service lines in heart and vascular surgery, oncology, and pediatrics have been organized since 2001, and report directly to hospital leadership as a product line. Service line leadership consists of a combination of medical leaders plus representatives of hospital administration, and service lines are allowed direct access to resources for program development, marketing, and resource allocation. Measurements of patient numbers, market share, length of stay, net margin, and patient satisfaction have been gathered and compared with the preproduct line era. In the 3 service lines, UWHC has seen variable but steady growth in patient numbers, enhanced market share, positive net margins, and improved patient satisfaction during the period of measurement. During this same period, the insurance milieu has resulted in consistent downward pressure on reimbursement, which has been offset by improved patient care efficiency as measured by length of stay, enhanced preferred provider status, and gains in market share. Scorecard measures of quality are also being developed and show enhanced teaching and research opportunities for students and trainees as well as improved Press Ganey patient satisfaction scores. At UWHC, the development of a product line matrix consisting of 3 service lines has resulted in more patient care efficiency, enhanced patient satisfaction, improved margin for the hospital, and enlargement of teaching and research opportunities. The key

ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 Â 17.4 d) versus general surgery (8.7 Â 12.9), transplant (7.8 Â 11.6), oral-maxillofacial surgery (5.5 Â 4.2), and neurosurgery (4.47 Â 9.8) (all p

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