دورية أكاديمية
Residents as Leaders: Using a Delphi Process to Conduct an Institutional Preoperative Patient Optimization Quality Improvement Initiative.
| العنوان: | Residents as Leaders: Using a Delphi Process to Conduct an Institutional Preoperative Patient Optimization Quality Improvement Initiative. |
|---|---|
| المؤلفون: | Kane WJ; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Lynch KT; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Squeo GC; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Haywood NS; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Cramer CL; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Chancellor WZ; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Cohee AS; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Thames MR; the Department of Anesthesiology (Thames), University of Virginia Health System, Charlottesville, VA., Friel CM; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA., Hedrick TL; From the Department of Surgery (Kane, Lynch, Squeo, Haywood, Cramer, Chancellor, Cohee, Friel, Hedrick), University of Virginia Health System, Charlottesville, VA. |
| المصدر: | Journal of the American College of Surgeons [J Am Coll Surg] 2022 Feb 01; Vol. 234 (2), pp. 176-181. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 9431305 Publication Model: Print Cited Medium: Internet ISSN: 1879-1190 (Electronic) Linking ISSN: 10727515 NLM ISO Abbreviation: J Am Coll Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2022- : [Baltimore, MD] : Lippincott Williams & Wilkins, Inc. Original Publication: Chicago, Ill. : The College, c1994- |
| مواضيع طبية MeSH: | Anesthesiology* , Internship and Residency*, Academic Medical Centers ; Education, Medical, Graduate ; Humans ; Quality Improvement ; Surveys and Questionnaires |
| مستخلص: | Background: Many residency programs struggle to meet the ACGME requirement for resident participation in quality improvement initiatives. Study Design: As part of an institutional quality improvement effort, trainees from the Departments of Surgery and Anesthesiology at a single academic medical center were teamed with institutional content experts in 7 key risk factor areas within preoperative patient optimization. A systematic review of each subject matter area was performed using the MEDLINE database. Institutional recommendations for the screening and management of each risk factor were developed and approved using modified Delphi consensus methodology. Upon project completion, an electronic survey was administered to all individuals who participated in the process to assess the perceived value of participation. Results: Fifty-one perioperative stakeholders participated in recommendation development: 26 trainees and 25 content experts. Residents led 6 out of 7 groups specific to a subject area within preoperative optimization. A total of 4,649 abstracts were identified, of which 456 full-text articles were selected for inclusion in recommendation development. Seventeen out of 26 (65.4%) trainees completed the survey. The vast majority of trainees reported increased understanding of their preoperative optimization subject area (15/17 [88.2%]) as well as the Delphi consensus method (14/17 [82.4%]) after participation in the project. Fourteen out of 17 (82.4%) trainees stated that they would participate in a similar quality improvement initiative again. Conclusions: We demonstrate a novel way to involve trainees in an institutional quality initiative that served to educate trainees in quality improvement, the systematic review process, Delphi methodology, and preoperative optimization. This study provides a framework that other residency programs can use to engage residents in institutional quality improvement efforts. (Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.) |
| References: | Accreditation Council for Graduate Medical Education. Common Program Requirements (Residency); c2020. Available at: http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRResidency2019.pdf . Accessed December 17, 2020. Weiss KB, Bagian JP, Wagner R. CLER pathways to excellence: expectations for an optimal clinical learning environment (executive summary). J Grad Med Educ. 2014;6:610–611. Baxter K, Petz C, Middleton JL, et al. Re-thinking how we teach quality improvement: adding meaning to an ACGME requirement. J Gen Intern Med. 2019;34:1662–1667. Wong BM, Etchells EE, Kuper A, et al. Teaching quality improvement and patient safety to trainees: a systematic review. Acad Med. 2010;85:1425–1439. Patow CA, Karpovich K, Riesenberg LA, et al. Residents’ engagement in quality improvement: a systematic review of the literature. Acad Med. 2009;84:1757–1764. American College of Surgeons. About Strong for Surgery; c2021. Available at: https://www.facs.org/quality-programs/strong-for-surgery/about . Accessed July 27, 2021. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490. Humphrey-Murto S, Varpio L, Wood TJ, et al. The use of the Delphi and other consensus group methods in medical education research: a review. Acad Med. 2017;92:1491–1498. Francis NK, Sylla P, Abou-Khalil M, et al. EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice. Surg Endosc. 2019;33:2726–2741. Gorter RR, Eker HH, Gorter-Stam MA, et al. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Surg Endosc. 2016;30:4668–4690. Hu QL, Fischer CP, Wescott AB, et al. Evidence review for the American College of Surgeons Quality Verification part I: building quality and safety resources and infrastructure. J Am Coll Surg. 2020;231:557–569.e1. Ellrodt AG. Introduction of total quality management (TQM) into an internal medicine residency. Acad Med. 1993;68:817–823. Brown A, Lafreniere K, Freedman D, et al. A realist synthesis of quality improvement curricula in undergraduate and postgraduate medical education: what works, for whom, and in what contexts? BMJ Qual Saf. 2021;30:337–352. Jones AC, Shipman SA, Ogrinc G. Key characteristics of successful quality improvement curricula in physician education: a realist review. BMJ Qual Saf. 2015;24:77–88. |
| معلومات مُعتمدة: | T32 CA163177 United States CA NCI NIH HHS |
| تواريخ الأحداث: | Date Created: 20220225 Date Completed: 20220429 Latest Revision: 20230826 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1097/XCS.0000000000000032 |
| PMID: | 35213438 |
| قاعدة البيانات: | MEDLINE |
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