Time Out for Teaching: Implementing a Post-Procedure Time Out to Improve Surgical Evaluations

Abstract

Faculty Advisor: Arthur Ollendorff, MD PURPOSE: To increase surgical evaluations by implementing a post-procedure Time Out for teaching. BACKGROUND: Compliance with intra-operative resident feedback and use of myTIPreport evaluations is poor. Feedback with completed evaluations is vital to improving surgical competence and compliance with ACGME milestones. METHODS: Post procedure Time Out for Teaching was implemented after gynecologic surgery to remind faculty to complete evaluations. A paper myTIPreport evaluation was provided in each operating room. Compliance goal was 80%. Evaluations were completed prior to leaving the operating room. PDSA cycles were used to introduce and evaluate this process. Using T-test, we compared completion rates prior to implementation of the Time Out. We removed the paper evaluations and continued PDSA cycles with the Time Out and electronic evaluations only. We compared completion rates of Time Out with paper evaluations to those with electronic evaluations. RESULTS: Implementing the Time Out with paper evaluations significantly improved compliance from 6/101 (5.9%) to 74/90 (82%, P<.01). When paper was removed, there was no significant difference in completed evaluations with Time Out alone (P=.14). Evaluation using chi squared and Fisher's exact tests showed completion rates with paper to be 11.36 times higher than with electronic evaluations (P<.0001). DISCUSSION: Adding a Post-procedure Time Out to remind faculty to complete intra-operative evaluations did improve compliance. However, having a paper evaluation proved to increase compliance more than the Time Out with electronic evaluations. We plan to continue the Time Out for Teaching process, but will give faculty the option to complete evaluations on paper.