Coaching Intervention to Improve Technical Skill in Surgery

指导干预以提高手术技术技能

• 批准号: 8671870
• 负责人: NANCY J BIRKMEYER
• 金额: $ 43.97万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8671870
• 关键词: Accreditation; Animals; Athletic; Board Certification; Businesses; Cardiac; Caring; Clinical; Clinical Skills; Complex; Complication; Control Groups; Controlled Study; Country; Data; Development; Educational process of instructing; Evaluation; Event; Feedback; Gastric Bypass; Healthcare; Hemorrhage; Hospitals; Infection; Inpatients; Intervention; Kidney Failure; Laboratories; Lead; Learning; Measures; Medical; Michigan; Morbidity - disease rate; Operating Rooms; Operative Surgical Procedures; Outcome; Patients; Performance; Perioperative Care; Policy Maker; Postoperative Complications; Procedures; Registries; Reporting; Research; Research Infrastructure; Respiratory Failure; Risk; Safety; Site; Structure; Surgeon; System; Techniques; Thromboembolism; Training; United States; Variant; Venous; Videotape; Wisconsin; Work; adverse outcome; bariatric surgery; base; beneficiary; continuing medical education; follow-up; improved; innovation; peer; population based; programs; public health relevance; skills; therapy development

DESCRIPTION (provided by applicant): Coaching Intervention to Improve Technical Skill in Surgery Each year in this country more than 150,000 patients undergoing major inpatient surgery die, and many more suffer serious complications leading to major long term morbidity. These important outcomes vary widely across hospitals and surgeons, suggesting large opportunities for improvement. While most improvement efforts have focused on general aspects of perioperative care, emerging evidence suggests that the most important strategy for reducing adverse outcomes of surgery may be to improve the proficiency of the operating surgeon. In this context, we will build on our prior work evaluating technical quality in the Michigan Bariatric Surgery Collaborative (MBSC) to implement a statewide skill development intervention. The MBSC is the perfect laboratory for such a study, with the existing infrastructure to measure technical quality in place, a clinical registry with outcomes data for more than 40,000 consecutive bariatric surgery procedures, and a collaborative network of 70 surgeons from 35 hospitals who have a track-record of participating in both the rating of technical skills and in population-based improvement efforts. Our specific aims are to develop a coaching intervention to improve technical skill and to evaluate its impact on surgical skills and clinical outcomes. Thi study will be highly innovative as the first large-scale study to apply coaching to improve technical skills among practicing surgeons. Results from this study will have immediate impact on surgeons, policymakers, and patients in need of surgery. Surgeons can build on this work to further augment large-scale quality improvement programs to focus on improving technical skill. Policy makers could develop similar programs and encourage surgeons to participate in them to achieve accreditation or board-certification. Ultimately, patients will be the beneficiaries of thi research as their surgeons become more skilled and they suffer fewer postoperative complications.

描述（由申请人提供）：提高手术技术技能的指导干预 在这个国家，每年有超过 150,000 名接受大型住院手术的患者死亡，还有更多的患者遭受严重并发症，导致严重的长期发病。这些重要的结果在不同的医院和外科医生之间存在很大差异，表明有很大的改进机会。虽然大多数改进工作都集中在围手术期护理的一般方面，但新出现的证据表明，减少手术不良后果的最重要策略可能是提高手术外科医生的熟练程度。在这种背景下，我们将在之前评估密歇根减肥手术合作组织 (MBSC) 技术质量的工作基础上，实施全州范围的技能发展干预措施。 MBSC 是进行此类研究的完美实验室，拥有现有的基础设施 为了衡量现有的技术质量，我们建立了一个包含超过 40,000 例连续减肥手术结果数据的临床登记系统，以及一个由来自 35 家医院的 70 名外科医生组成的协作网络，他们拥有参与技术技能评级和基于人群的改进工作的记录。我们的具体目标是开发一种指导干预措施，以提高技术技能并评估其对手术技能和临床结果的影响。作为第一个应用辅导来提高执业外科医生技术技能的大规模研究，这项研究将具有高度创新性。这项研究的结果将对外科医生、政策制定者和需要手术的患者产生直接影响。外科医生可以在这项工作的基础上进一步扩大大规模的质量改进计划，以专注于提高技术技能。政策制定者可以制定类似的计划，并鼓励外科医生参与其中以获得认证或委员会认证。最终，患者将成为这项研究的受益者，因为他们的外科医生变得更加熟练，并且他们遭受的术后并发症更少。