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Emergency Undocking in Robotic Surgery: A Simulation Curriculum

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Published on: May 20, 2018

Development of an emergency general surgery process improvement program.

Matthew J Bradley^1,2, Angela T Kindvall¹, Ashley E Humphries^1,2

¹1Department of Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889 USA.

Patient Safety in Surgery

|July 7, 2018

Summary

This summary is machine-generated.

Implementing an Emergency General Surgery (EGS) Process Improvement (PI) program, similar to trauma PI, enhanced institutional PI proficiency. This novel approach increased PI events by 49%, maintaining readiness in military trauma centers.

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Area of Science:

Surgical Process Improvement
Emergency General Surgery
Trauma Surgery

Background:

Military trauma centers face challenges maintaining Process Improvement (PI) programs due to decreased combat casualties.
Emergency General Surgery (EGS) patients share similarities with trauma patients.
A novel EGS PI program was developed to address these challenges.

Purpose of the Study:

To describe the implementation of a new EGS PI program.
To evaluate the effect of the EGS PI program on institutional PI proficiency.
To assess the impact of EGS PI events on the overall trauma PI program.

Main Methods:

An EGS registry was established in 2013 with AAST-based inclusion criteria.
Dedicated EGS registrar and PI coordinator roles were created in 2015.
A formal EGS PI program commenced in 2016, with pre- and post-program data analysis.

Main Results:

In 2016, 1001 EGS consults were managed, with 444 meeting registry criteria.
Eighty-two patients experienced 131 PI events, including readmissions, unplanned interventions, and ICU admissions.
The capture of EGS PI events resulted in a 49% increase in PI events compared to 2015.

Conclusions:

The EGS PI program led to increased patient volume and PI events.
Extending trauma PI principles to EGS can enhance military and lower-volume trauma center readiness.
The EGS PI program demonstrated significant benefits in maintaining institutional PI proficiency.