Coaching Intervention to Improve Technical Skill in Surgery

描述（由申请人提供）：提高外科技术技能的指导干预每年在这个国家有超过15万接受重大住院手术的患者死亡，还有更多的患者患有严重的并发症，导致严重的长期发病率。这些重要的结果在不同的医院和外科医生之间差异很大，这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医生的熟练程度。在此背景下，我们将在先前密歇根州减肥外科合作中心（MBSC）评估技术质量的基础上，实施一项全州范围的技能发展干预。MBSC拥有现有的基础设施，是进行此类研究的完美实验室

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.