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Improving IV Insulin Administration in a Community Hospital
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Proficiency-based training and credentialing can improve patient outcomes and decrease cost to a hospital system.

Vernissia Tam1, Jeffrey Borrebach2, Stefanie Altieri Dunn2

  • 1Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

American Journal of Surgery
|August 13, 2018
PubMed
Summary
This summary is machine-generated.

Proficiency-based robotic training for general surgeons significantly reduced operative times and hospital costs in hernia repair cases. This training curriculum proved effective in improving surgical efficiency and reducing expenses.

Keywords:
Operative timeProficiencyRobotic inguinal herniaSimulation

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Area of Science:

  • Surgical Education
  • Minimally Invasive Surgery
  • Health Economics

Background:

  • Proficiency-based robotic training enhances surgical skill acquisition.
  • Previous studies have not demonstrated improved patient outcomes or quality measures from such training.

Purpose of the Study:

  • To evaluate the impact of a proficiency-based robotic training curriculum on operative times and costs in general surgery.
  • To determine if surgeons completing the training had improved efficiency in robotic hernia repairs.

Main Methods:

  • Board-certified general surgeons participated in an optional proficiency-based robotic training.
  • Outcomes from 210 robotic hernia cases were analyzed.
  • Multivariable analysis adjusted for patient and surgical variables to assess operative times.

Main Results:

  • Surgeons who completed training had shorter observed-to-expected operative time ratios (OTR) compared to those who did not (p=0.03).
  • Bilateral repairs and incarceration were associated with longer operative times, while female patients and increasing case order were associated with shorter times.
  • Trainees achieved an average savings of $1207 (20% reduction) per robotic hernia case.

Conclusions:

  • A structured proficiency-based robotics training curriculum effectively reduces operative times.
  • This training approach leads to significant cost savings in robotic hernia repairs.
  • Proficiency-based training is a valuable tool for enhancing surgical efficiency and economic outcomes.