Table 3

Multicentre positive deviance seminar recommendations

Multicentre positive deviance seminars
Topic	Recommendations
Prolonged alveolar air leak	Discontinue suction as early as possible provided there is no contraindication or profound lung collapse
Atrial fibrillation	Avoid stopping beta-blockers perioperatively Give pre-emptive magnesium administration (eg, 2 g in intravenous in recovery room, on POD 1 and 2) following pulmonary resection
Length of stay	MIS lobectomy Preoperative Counsel patients regarding smoking cessation and exercise preoperatively Advise patients they will go home POD 1 or 2 with or without chest tube unless there is a medical reason to delay discharge Intraoperative Avoid use of ntravenous PCA analgesia for routine VATS lobectomy; use po analgesia Routine use of 1 chest tube, 24 French No epidural necessary routinely Postoperative Remove chest tubes of drainage <450 cc and it is not an alarming bodily fluid Avoid routine use of suction postoperatively Selective use of chest X-rays postoperative Avoid use of chest X-ray post-tube removal Routine use of nursing tube removal protocols Open lobectomy Preoperative Counsel patients regarding smoking cessation and exercise preoperatively Intraoperative Routine use of 1 chest tube, 24 French Postoperative Remove chest tubes of drainage <450 cc and it is not an alarming bodily fluid Avoid routine use of suction postoperatively Selective use of chest X-rays postoperative Avoid use of chest X-ray post-tube removal Routine use of nursing tube removal protocols

PCA, patient controlled analgesia; POD, postoperative day; VATS, Video Assisted Thoracic Surgery.