W. E. Raible1, G. Luetters1, A. Bhakta1, T. D. Beyer1, S. C. Stain1 1Albany Medical College,Department Of Surgery,Albany, NY, USA
Introduction:
The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) tracks 30-day surgical outcomes. Improvement in clinical outcomes has been displayed by providing NSQIP data to surgeons. Recently, the ACS created the Quality In-Training Initiative (QITI). QITI is provides surgical residents with their own NSQIP outcomes data. We aim to show that current surgical residents have limited knowledge of their personal clinical outcomes. With current resident duty hour requirements and increasing shift towards outpatient management of diseases, we believe surgical residents’ perception of their outcomes is anecdotal.
Methods:
IRB approval was obtained and an anonymous electronic survey was distributed to general surgery program coordinators for distribution to general surgery residents. Objective data collected includes training program, post-graduate year, major cases logged, and NSQIP and/or QITI participation. Subjective data includes resident perception of post-op length of stay (LOS), surgical site infection (SSI), readmission, and death. The remaining data collected relates to the resident’s perceived benefit of receiving personal surgical outcome data, the frequency resident’s follow patients post-operatively and until discharge. Statistical analysis of this data was performed.
Results:
To date, 40 survey responses were received. Residents training in academic programs included 28/40 (70%). There are 24/40 (60%) PGY-3 or above residents. The average number of cases logged amongst respondents was 503. Most residents’ programs participate in NSQIP, 37/40 (92.5%). However, only 4/40 (10%) of residents’ programs participate in QITI. All programs that participate in QITI provide outcomes data to the residents, of which all residents report ‘excellent’ knowledge of their surgical outcomes (LOS, SSI, readmission, deaths). From the programs that do not participate in QITI, resident knowledge of surgical outcomes was ‘fair,’ 32/36 (89%) ‘agree’ or ‘strongly agree’ QITI outcomes data would improve their training, and 27/36 (77%) ‘agree’ or ‘strongly agree’ QITI outcomes data would improve their surgical outcomes. Lastly, 36/40 (90%) were ‘likely’ or ‘highly likely’ to follow their post-operative patients to discharge, but only 5/40 (12.5%) were ‘likely’ or ‘highly likely’ to see their post-operative patients in clinic.
Conclusions:
Resident perception of their personal postoperative outcomes (LOS, SSI, readmission, death) is limited without the use of QITI data. Further contributing to residents being unaware of postoperative outcomes may be the limited outpatient follow up. Residents believe receiving QITI data will improve their training experience and improve their postoperative outcomes, which we plan to study in a future trial.