Effectiveness of strict credentialing and proctoring guidelines on outcomes of laparoscopic cholecystectomy in a community hospital.

UNLABELLED: Strict credentialing and proctoring guidelines were set up prior to initiating a program of laparoscopic cholecystectomy at the Good Samaritan Hospital in Downers Grove, Illinois. This is a private 386-bed community hospital. At the inception of the program, there were 15 general surgeons who were going to participate in this program. In 1992, there were 20 general surgeons performing the laparoscopic cholecystectomy (LC). The following guidelines were approved by the Credentials Committee and authorized by the Executive Committee: A. Training: A SAGES-approved or equivalent course in LC, meeting or exceeding SAGES guidelines. B. Proctoring: Proctoring of 10 LC cases, prior to operating independently. C. Prevention of injuries: Two surgeons credentialed in LC to operate as a surgeon-cosurgeon team. D. EVALUATION: 100% concurrent review of all LC cases.