Impact of elective case postponement secondary to COVID-19 on general surgery residents’ experience: operative cases logged at three academic teaching hospitals

Abstract Background Patient safety is an important concept in resident education. To date, few studies have assessed resident perceptions of patient safety across different specialties. Objective The study explored residents' views on patient safety across the specialties of internal medicine, general surgery, and diagnostic radiology, focusing on common themes and differences. Methods In fall 2012, interviews of small groups of senior residents in internal medicine, general surgery, and diagnostic radiology were conducted at 3 academic medical centers and 3 community teaching hospitals in 3 major US metropolitan areas. In total, 33 residents were interviewed. Interviews used interactive discussion to explore multiple facets of patient safety. Results Residents identified lack of information, common errors, volume and acuity of patients, and inadequate supervision as major risks to patient safety. Specific threats to patient safety included communication problems, transitions of care, information technology interface issues, time constraints, and work flow. Residents disclosed that reporting safety issues was viewed as burdensome and carrying some degree of risk. There was variability as to whether residents would report safety threats they encountered. Conclusions Residents are aware of threats to patient safety and have a unique perspective compared with other health care professionals. Transitions of care and communication problems were the most common safety threats identified by the residents interviewed.

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Introducing Delirium Screening To ICU Nurses In Two Academic Teaching Hospitals

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a1465 ◽

2012 ◽

Author(s):

S. J. Hsieh ◽

Mirian Martinez ◽

Purnema Madahar ◽

Krishna Aparanji ◽

S. Selesny ◽

...

Keyword(s):

Teaching Hospitals ◽

Academic Teaching

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Type of facility influences lengths of stay of children presenting to high volume emergency departments

BMC Pediatrics ◽

10.1186/s12887-020-02400-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Rhonda J. Rosychuk ◽

Brian H. Rowe

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Emergency Departments ◽

High Volume ◽

Population Based ◽

Initial Assessment ◽

Teaching Hospitals ◽

Emergency Department Crowding ◽

Academic Teaching ◽

The Impact

Abstract Background Emergency department crowding may impact patient and provider outcomes. We describe emergency department crowding metrics based on presentations by children to different categories of high volume emergency departments in Alberta, Canada. Methods This population-based retrospective study extracted all presentations made by children (age < 18 years) during April 2010 to March 2015 to 15 high volume emergency departments: five regional, eight urban, and two academic/teaching. Time to physician initial assessment, and length of stay for discharges and admissions were calculated based on the start of presentation and emergency department facility. Multiple metrics, including the medians for hourly, facility-specific time to physician initial assessment and length of stay were obtained. Results About half (51.2%) of the 1,124,119 presentations were made to the two academic/teaching emergency departments. Males presented more than females (53.6% vs 46.4%) and the median age was 5 years. Pediatric presentations to the three categories of emergency departments had mostly similar characteristics; however, urban and academic/teaching emergency departments had more severe triage scores and academic/teaching emergency departments had higher admissions. Across all emergency departments, the medians of the metrics for time to physician initial assessment, length of stay for discharges and for admission were 1h11min, 2h21min, and 6h29min, respectively. Generally, regional hospitals had shorter times than urban and academic/teaching hospitals. Conclusions Pediatric presentations to high volume emergency departments in this province suggest similar delays to see providers; however, length of stay for discharges and admissions were shorter in regional emergency departments. Crowding is more common in urban and especially academic emergency departments and the impact of crowding on patient outcomes requires further study.

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Introducing clinical pathways as a strategy for improving care

Journal of integrated Care Pathways ◽

10.1258/jicp.2008.008008 ◽

2008 ◽

Vol 12 (2) ◽

pp. 56-60 ◽

Cited By ~ 1

Author(s):

Sander Feuth ◽

Leonie Claes

Keyword(s):

Clinical Pathway ◽

Clinical Pathways ◽

Hospital Staff ◽

Project Teams ◽

Teaching Hospitals ◽

Specific Situation ◽

Pathway Network ◽

Academic Teaching ◽

Care Processes ◽

Under Construction

This article describes the way in which Catharina Hospital introduced clinical pathways to its workforce. The hospital, one of the largest non-academic teaching hospitals in The Netherlands, developed the first clinical pathway in 2004. Since then, clinical pathways have been presented as a strategic tool for improving care. In preparation for an organization-wide project, a team investigated and adapted the methodology as designed by the Clinical Pathway Network to the specific situation of Catharina Hospital. Staff were educated, which in return provided project teams with methodology and tools for development. Started small, the aim of the project is to achieve a snowball effect in the use of clinical pathways. Having started in 2006, six pathways are currently under construction, more of which are considered for development. An evaluation of the methodology and results in the summer of 2007, showed that the method was of great help in optimizing care processes and developing multidisciplinary agreements.

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Operative Confidence Among U.S General Surgery Residents

The American Surgeon ◽

10.1177/00031348211038588 ◽

2021 ◽

pp. 000313482110385

Author(s):

Adel Elkbuli ◽

Haley Ehrlich ◽

Toria Gargano ◽

Kevin Newsome ◽

Huazhi Liu ◽

...

Keyword(s):

General Surgery ◽

Online Survey ◽

Influential Factors ◽

University Teaching ◽

Teaching Hospitals ◽

Binary Outcomes ◽

Case Volume ◽

General Surgery Residency ◽

Operative Case ◽

Community Teaching

Background General surgery residents (GSRs) must develop operative autonomy skills to practice independently after graduation. We aim to investigate perceived confidence and operative autonomy of GSR physicians in order to identify and address influential factors. Methods A 28-question anonymous online survey was distributed to 23 United States general surgery residency programs. Multivariable logistic regression was used for calculating the adjusted odds ratio (aOR) for binary outcomes. Significance was defined as P-values ≤ .05 or 95% confidence intervals (CIs) >1 or <1. Results There were 120/558 (21.5%) GSR respondents. General surgery residents with >200 overall operative case volume reported significantly higher confidence with minor cases (P = .05) and major cases (P = .02). General surgery residents that performed both minor and major surgeries reported higher confidence with minor cases at 85.7% compared to GSRs that performed mostly minor surgeries (64.7%) and mostly major surgeries (62.5%). General surgery residents who performed >50 minor surgeries during their PGY 1 and 2 were less confident with major cases than GSRs who performed <50 minor surgeries (aOR: 19.98, 95% CI: 1.26, 318). General surgery residents from community teaching hospitals reported higher confidence with major and minor cases than GSRs from university teaching hospitals and combined programs. Conclusion Increased case volume, predominant case type, early surgical experience during PGY 1 and 2 years, and training at community teaching hospitals were identified as the most important factors that positively influence perception of operative confidence and autonomy among GSRs. These may have important implications in the development of future surgeons.

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Sub-segmental pulmonary embolism in three academic teaching hospitals: a review of management and outcomes

Journal of Thrombosis and Haemostasis ◽

10.1111/jth.12803 ◽

2015 ◽

Vol 13 (2) ◽

pp. 214-218 ◽

Cited By ~ 19

Author(s):

J. Goy ◽

J. Lee ◽

O. Levine ◽

S. Chaudhry ◽

M. Crowther

Keyword(s):

Pulmonary Embolism ◽

Teaching Hospitals ◽

Academic Teaching

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Towards an Open Medical School without Checkerboards during the COVID-19 Pandemic: How to Flexibly Self-Manage General Surgery Practices in Hospitals?

Healthcare ◽

10.3390/healthcare9060743 ◽

2021 ◽

Vol 9 (6) ◽

pp. 743

Author(s):

Héctor Guadalajara ◽

Álvaro Palazón ◽

Olatz Lopez-Fernandez ◽

Pilar Esteban-Flores ◽

José Miguel Garcia ◽

...

Keyword(s):

General Surgery ◽

Teaching Style ◽

Teaching Styles ◽

Mobile App ◽

Teacher Involvement ◽

Teaching Hospitals ◽

Structured Interviews ◽

Self Directed Learning ◽

Clinical Culture ◽

Directed Learning

Background: Can we create a technological solution to flexibly self-manage undergraduate General Surgery practices within hospitals? Before the pandemic, the management of clerkships was starting to depend less on checkerboards. This study aims to explore undergraduates’ perceptions of doing rotations in teaching hospitals using different teaching styles and elicit their views regarding the options of managing practices to design a mobile app that substitutes for checkerboards. Methods: In this sequential exploratory mixed methods study, 38 semi-structured interviews at a teaching hospital were conducted. The data was used to survey 124 students doing their rotations in four teaching hospitals during the first wave of COVID-19. Results: 21 themes highlighted concerns related to the practices, the teacher involvement in the students’ education, and the students’ adaptation to clinical culture. The students reported positive perceptions concerning self-managing and organizing practices via a mobile application. However, problems emerged regarding transparency, the lack of feedback, and the need for new tools. Regarding the teaching styles, the facilitator and personal models were perceived as optimal, but the personal style had no effect on using or not using a tool. Conclusions: A mobile-learning application designed like an educational opportunities’ manager tool can probably promote self-directed learning, flexible teaching, and bidirectional assessments. However, teachers who employ a personal teaching style may not need either checkerboards or a tool. This solution supports teaching at hospitals in pandemic times without checkerboards.

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