GME Patient Safety Quality and Innovation Symposium

Issues Addressed/Background: The quality and efficiency of surgical operations are crucial for both patient outcomes and healthcare institutions. Despite advancements in surgical techniques and technology, operational issues persist, leading to suboptimal performance, increased costs, and patient dissatisfaction. Surgeons in the UCSDH operating rooms (ORs) under-report adverse events and process improvement concerns through the existing iReport system, hampering the ability of the system to provide safe and efficient patient care. Traditional surgeon feedback methods are often too broad given inclusion of patient safety issues (e.g. iReport), have a high access barrier, and/or limited in effectiveness, necessitating an innovative approach to address these challenges.

Description of Project: This project aims to design and implement a specialized surgeon feedback platform tailored to address operational issues in the perioperative environment. The platform was developed using a multidisciplinary approach, integrating insights from surgeons, healthcare administrators, and information technology experts. Features included secure submission of feedback, automated input of relevant case information where applicable, and the ability to promote closed-loop communication as well as identify trends and patterns in operational issues. Additionally, the platform enabled the sharing of best practices and the development of targeted solutions. A survey was sent to surgeons before and after implementation of this platform to gauge trends in reporting and impact of the platform.

Lessons Learned/Expected Outcomes: The implementation of the surgeon feedback platform has demonstrated several key benefits. First, the streamlined submission process encouraged more frequent and detailed feedback from surgeons, leading to increased engagement and a heightened sense of ownership in resolving operational issues. Second, the real-time analysis and visualization tools enabled faster identification of trends and patterns, and decrease in average days to close, which allowed surgical teams to proactively address recurring problems. Third, the facilitated communication among surgical teams fostered a culture of collaboration, promoting the exchange of innovative ideas and solutions.Preliminary survey data from the pre-implementation phase are demonstrate that surgeons used a diverse array of venues to escalate operational issues, and the most common specific complaint was the lack of knowing if and when a solution to the report was made. Post-implementation survey data is forthcoming, and we hypothesize that the new platform will be utilized forreporting operational issues appropriately, and increase satisfaction with closed-loop communication.

Recommendations: Based on the success of the specialized surgeon feedback platform, we recommend the following: (1) Encourage healthcare institutions to adopt similar feedback platforms for a more targeted approach in addressing operational issues in the perioperative environment. (2) Prioritize a multidisciplinary approach when designing feedback platforms to ensure they cater to the unique needs of the perioperative community. (3) Promote a culture of continuous learning and collaboration among perioperative teams, enabling them to share best practices and innovative solutions. (4) Conduct further research and survey continue to gauge impact and refine the platform, and the exploration of applications in other medical specialties.By embracing such innovative approaches, healthcare institutions can further enhance the quality and efficiency of perioperative care, ultimately benefiting patients and healthcare providers alike.

Figure 1. Surgeon Feedback Platform a. QR code for access, b. computer reporting screen, c. mobile reporting screen.

Figure 2. Pre-Implementation Survey Results – “If any, what platform or method do you currently use to report OR operational issues, such as with surgical equipment, sterilization, or operating room staffing?”