IMPROVING SURGICAL ACCESS: THE VANCOUVER EXPERIENCE
Bibliographic record
Abstract
The 2004 United Kingdom (UK) National Health Service (NHS) Improvement Plan stated that: “By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment.” Over the same time period, on the other side of the Atlantic, the provincial government of British Columbia (BC) allocated funding for a specialist centre accommodating 2 new operating rooms and a 38 bed inpatient ward. The centre was designed to augment existing surgical capacity for hip and knee joint replacement by 1600 cases per year to help achieve the Canadian waiting time target of 26 weeks. Core design principles were: to improve patient flow through a centralised joint clinic designed to assess patients with osteoarthritis and related disorders; to maintain the connection between patient and surgeon throughout the entire care pathway; to ‘ring-fence’ dedicated operating room capacity and ward space in order to minimise the risk of surgical cancellations; and to reduce the mean length of inpatient post-operative stay to 4 days. Analysis of the programme9s results showed: 1609 and 1602 joint replacements were performed during each of the first two respective years of operation – an additional 16% of provincial capacity, thus achieving the headline target; a mean patient satisfaction score of 4.7 out of 5; a self-reported complication rate of 4.4% (47 of the first 1078 patients surveyed); a mean theatre time of 1hr 45min, a mean post-anaesthesia recovery stay of 2hr 4min and a mean post-surgical length of stay of 3.4 days; and delivery of the programme within budget. By maintaining the patient/surgeon relationship and adhering to other key principles a high standard of care has been achieved in this programme with high rates of patient and surgeon satisfaction and a low complication rate.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".