Jennifer N Ervin1, C Ann Vitous, Emily E Wells, Sarah L Krein, Christopher R Friese, Amir A Ghaferi. 1. *Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor †Center for Healthcare Outcomes and Policy, Department of Surgery, University of Michigan ‡Veteran Affairs Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor §Department of Internal Medicine, University of Michigan Medical School, Ann Arbor ¶University of Michigan School of Nursing, Ann Arbor. 6University of Michigan Rogel Cancer Center, Ann Arbor.
Abstract
OBJECTIVE: To understand the effectiveness of Rescue Improvement Conference, a forum that addresses failure to rescue (FTR). SUMMARY BACKGROUND DATA: Every year over 150,000 patients die after elective surgery in the United States. FTR is the phenomenon whereby delayed recognition and/or response to serious surgical complications leads to a progressive cascade of adverse events culminating in death. Rescue Improvement Conference is an adapted version of the Ottawa-style M&M conference, designed to address common contributors to FTR: ineffective communication and inadequate problem solving. METHODS: Mixed methods data were used to evaluate Rescue Improvement Conference, a bi- monthly forum that was first introduced in our academic medical center in 2018. Conference effectiveness data were collected via survey and open-text responses after five conferences between September 2018 and February 2020. We focused on five indicators of effectiveness: educational value, conference takeaways, discussion time, changes to surgical practice, and actionable opportunities for improvement. Twelve surgical faculty and house staff also provided feedback during semi- structured interviews. Qualitative data were analyzed using thematic analysis. RESULTS: Conference attendees (N = 140) felt that Rescue Improvement Conference was effective-all five indicators had mean scores above five on Likert scales. The qualitative data supports the quantitative findings, and three additional themes emerged: Rescue Improvement Conference enables the representation of diverse voices, promotes interdisciplinary collaboration, and encourages multilevel problem solving. CONCLUSIONS: Rescue Improvement Conference has the potential to support other surgical departments in developing system-level strategies to recognize and manage postoperative complications by providing stakeholders a forum to identify and discuss factors that contribute to FTR.
OBJECTIVE: To understand the effectiveness of Rescue Improvement Conference, a forum that addresses failure to rescue (FTR). SUMMARY BACKGROUND DATA: Every year over 150,000 patients die after elective surgery in the United States. FTR is the phenomenon whereby delayed recognition and/or response to serious surgical complications leads to a progressive cascade of adverse events culminating in death. Rescue Improvement Conference is an adapted version of the Ottawa-style M&M conference, designed to address common contributors to FTR: ineffective communication and inadequate problem solving. METHODS: Mixed methods data were used to evaluate Rescue Improvement Conference, a bi- monthly forum that was first introduced in our academic medical center in 2018. Conference effectiveness data were collected via survey and open-text responses after five conferences between September 2018 and February 2020. We focused on five indicators of effectiveness: educational value, conference takeaways, discussion time, changes to surgical practice, and actionable opportunities for improvement. Twelve surgical faculty and house staff also provided feedback during semi- structured interviews. Qualitative data were analyzed using thematic analysis. RESULTS: Conference attendees (N = 140) felt that Rescue Improvement Conference was effective-all five indicators had mean scores above five on Likert scales. The qualitative data supports the quantitative findings, and three additional themes emerged: Rescue Improvement Conference enables the representation of diverse voices, promotes interdisciplinary collaboration, and encourages multilevel problem solving. CONCLUSIONS: Rescue Improvement Conference has the potential to support other surgical departments in developing system-level strategies to recognize and manage postoperative complications by providing stakeholders a forum to identify and discuss factors that contribute to FTR.
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