Residency Board Certification Requirements and Preoperative Surgical Home Activities in the United States

Cline, Kayla M.; Roopani, Rahil; Kash, Bita A.; Vetter, Thomas R.

doi:10.1213/ane.0000000000000772

Cited by 10 publications

(2 citation statements)

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“…In addition, we found that surgical settings have distinctive conditions for measuring team effectiveness relative to other primary care or ambulatory care. As evidenced by programs such as Enhanced Recovery After Surgery (ERAS), the Perioperative Surgical Home (PSH), and Medicare's Comprehensive Care for Joint Replacement Model (CJR), the operating room has become a critical setting for team-based care delivery [58][59][60] ; thus, more validated survey instruments focused on surgical action teams are needed. Further development of specific team effectiveness evaluation tools in various settings, such as chronic illness care, home care, long-term care, and ambulatory care, can enhance continuous quality improvements and patient outcomes in the future.…”

Section: Discussionmentioning

confidence: 99%

Measuring Team Effectiveness in the Health Care Setting: An Inventory of Survey Tools

Kash

Cheon

Halzack

et al. 2018

Health�Serv�Insights

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Background:Guidance for measuring team effectiveness in dynamic clinical settings is necessary; however, there are no consensus strategies to help health care organizations achieve optimal teamwork. This systematic review aims to identify validated survey instruments of team effectiveness by clinical settings.Methods:PubMed, MEDLINE, and ISI Web of Knowledge were searched for team effectiveness surveys deployed from 1990 to 2016. Validity and reliability were evaluated using 4 psychometric properties: interrater agreement, internal consistency, content validity, and structural integrity. Two conceptual frameworks, the Donabedian model and the Command Team Effectiveness model, assess conceptual dimensions most measured in each health care setting.Results:The 22 articles focused on surgical, primary care, and other health care settings. Few instruments report the required psychometric properties or feature non-self-reported outcomes. The major conceptual dimensions measured in the survey instruments differed across settings. Team cohesion and overall perceived team effectiveness can be found in all the team effectiveness measurement tools regardless of the health care setting. We found that surgical settings have distinctive conditions for measuring team effectiveness relative to primary or ambulatory care.Discussion:Further development of setting-specific team effectiveness measurement tools can help further enhance continuous quality improvements and clinical outcomes in the future.

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Section: Discussionmentioning

confidence: 99%

Measuring Team Effectiveness in the Health Care Setting: An Inventory of Survey Tools

Kash

Cheon

Halzack

et al. 2018

Health�Serv�Insights

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“…These requirements encapsulate the general concept of POM and emphasize the absolute importance of continuity of care in and out of the operating room. However, there remains much opportunity to further implement pragmatic POM training that best positions future trainees for success in evolving care paradigms featuring comprehensive perioperative management 10 .…”

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confidence: 99%

Anesthesiology Residency Curriculum and Implementation of a Perioperative Surgical Home Curriculum: A Survey Study

Rinehart¹,

Seong²,

Alem³

et al. 2017

JEPM

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Background The perioperative surgical home (PSH) is a physician-led, interdisciplinary, and patient-centered model of perioperative care that focuses on patient outcomes and comprehensive care management. Many studies to date have looked at the clinical implementation of varied PSH models with promising results discussed. There are no studies directly examining concrete plans for the various Accreditation Council for Graduate Medical Education (ACGME) anesthesiology residency programs to implement augmented PSH training into curricula. The aim of this survey study was to better assess current residency training in PSH. Methods An 18-question survey developed by a team of research personnel familiar with the PSH was sent to all ACGME accredited anesthesiology training programs in the United States. Responses were quantified, and construct and external validity of the survey tool examined. Results 41% of the programs responded. 89% (95% CI 78-96%) of programs reported moderate or better understanding of the PSH. 34% (21-47%) had incorporated additional PSH training in the previous three years, and 32% (with no significant correlation to the previous group) had plans to integrate more training in the next 3 years. Conclusions Overall, the surveyed program directors voiced understanding of the value of the PSH model in patient care but remained hesitant to incorporate training specific to PSH into the anesthesiology residency curricula. Background Perioperative medicine (POM) is faced with major challenges in the cost and quality of care as evidenced by high complication and readmission rates as well as financial incentives to perform surgeries 1 . Some approaches to address this problem have focused on further expanding the role of anesthesiologists in the perioperative period and focusing on evidence-based standardization of surgical pathways. This is exemplified by models like the perioperative surgical home (PSH) 2 and enhanced recovery after surgery (ERAS) 3 . The PSH is a physician-led, interdisciplinary, and patient-centered model of perioperative care that focuses on patient outcomes and comprehensive care management 4 and has been a focus of the American Society of Anesthesiologists (ASA) in recent years. This evolving paradigm for surgical care has been shown to reduce costs while minimizing complications associated with the perioperative timeline 5 .

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Preoperative Consultations

Thilen¹,

Wijeysundera

2016

Anesthesiology Clinics

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Preoperative consultation is an important intervention that likely has most benefits for intermediate-risk to high-risk patients undergoing major surgery. Consultation rates are likely increasing and there is significant practice variation in the use of consultation. Consultations should be available within a well-organized and coordinated process of preoperative assessment. Preoperative consults should be accessible to anesthesia and surgical teams involved in the procedure and to the providers involved in postoperative care. The role of preoperative consultation should evolve as a rational approach and emerge as a value-based service. New payment methodologies are likely to facilitate appropriate use of this important resource.

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Residency Board Certification Requirements and Preoperative Surgical Home Activities in the United States

Cited by 10 publications

References 11 publications

Measuring Team Effectiveness in the Health Care Setting: An Inventory of Survey Tools

Measuring Team Effectiveness in the Health Care Setting: An Inventory of Survey Tools

Anesthesiology Residency Curriculum and Implementation of a Perioperative Surgical Home Curriculum: A Survey Study

Preoperative Consultations

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