P. I. Abbas1,2, I. J. Zamora1,2, S. C. Elder2, T. C. Lee1,2, J. G. Nuchtern1,2 1Baylor College Of Medicine,Michael E. DeBakey Department Of Surgery,Houston, TX, USA 2Texas Children’s Hospital,Division Of Pediatric Surgery,Houston, TX, USA
Introduction: The implementation of shorter resident work hour restrictions has increased the need for more faculty involvement for continuity of patient care. To address this need, a surgeon of the week (SOW) program was initiated at our institution in July 2013 to assign an attending surgeon to round on all pediatric surgery patients on the academic service. The purpose of this study was to assess the impact of the surgical rounder on care provided on the surgical floor.
Methods: This is a retrospective study comparing data before and after implementation of the SOW system. The goal was to assess the impact of SOW in three categories: patient care, patient safety, and nursing satisfaction. Administrative data were collected from July to December 2013 (post-implementation) and compared to July to December 2012 (pre-implementation). A 10-point Likert scale survey was administered to the daytime nursing /ancillary staff on the pediatric surgical floor to gauge the perceived effect of the SOW system on three areas of interest: nursing satisfaction, perceived patient satisfaction, and nursing to physician communication. Data are reported as means.
Results: As background, 6,752 separate inpatient encounters were documented at our institution for the entire fiscal year of 2013 with 5,541 operations performed at the main campus. When analyzing pre and post-implementation data, total inpatient E&M encounters increased after SOW implementation (3482 vs 4000, respectively), as did work RVUs. The total number of patient complaints decreased after implementation of the SOW with the reduction in patient safety reports accounting for a majority of the total decrease [Table].
Twenty of the daytime nursing staff on the pediatric surgical ward completed the satisfaction survey with 12 employed prior to the initiation of SOW. The overall satisfaction score of the SOW program among all 20 participants was 8.3. When the 12 employees who had experience before the SOW program were analyzed, there was a noted increase in satisfaction after the SOW program in all three areas [Table]. The Cronbach’s alpha coefficient for the overall survey was 0.95, 0.94 for nursing satisfaction, 0.95 for perceived patient satisfaction, and 0.95 for nursing to physician communication.
Conclusion: Initiation of the SOW program has improved patient care through the presence of a dedicated rounding surgeon, as evidenced by a decrease in patient safety complaints. Additionally, the SOW program increased work RVUs, led to an improved work environment with increased nursing staff satisfaction, and enhanced nursing-physician communication.
