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Related Experiment Video

Updated: Apr 6, 2026

The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
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The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time

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Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

Jelena Ivanovic1, Caitlin Anstee2, Tim Ramsay3

  • 1Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.

The Annals of Thoracic Surgery
|July 20, 2015
PubMed
Summary

Surgeon-specific outcome reports (SSORs) and continuous quality improvement (CQI) seminars can motivate surgeons to enhance patient care. Ongoing research will determine if these methods reduce postoperative adverse events.

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The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
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Area of Science:

  • Medical Quality Improvement
  • Surgical Outcomes Research
  • Health Professions Education

Background:

  • Postoperative adverse events were documented using the thoracic morbidity and mortality classification.
  • Surgeon-specific outcome reports (SSORs) were developed to promote self-assessment.
  • A divisional continuous quality improvement (CQI) program was implemented to enhance clinical performance.

Purpose of the Study:

  • To assess the impact of SSORs and CQI seminars on surgeon performance.
  • To identify facilitators and barriers to the implementation of SSORs and CQI.
  • To promote a culture of quality improvement within a surgical division.

Main Methods:

  • A mixed-methods study involving six thoracic surgeons.
  • Development and implementation of real-time, Web-based, risk-adjusted SSORs.
  • Conducting CQI seminars for results evaluation and discussion of quality improvement strategies.
  • Thematic analysis of interview transcripts to identify facilitators and barriers.

Main Results:

  • Surgeons expressed support for SSORs, recognizing their potential for improving patient care and professional development.
  • Perceived limitations of SSORs included challenges in measuring expertise, understanding risk adjustment, and fear of punitive actions.
  • CQI seminars fostered collegial discussions, though challenges with participation and follow-through were noted.

Conclusions:

  • Real-time performance feedback via SSORs can motivate surgeons to refine their practice.
  • CQI seminars provide a supportive environment for reviewing results and addressing issues.
  • Further research is needed to confirm if SSORs and CQI improve postoperative adverse event rates.