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Published on: February 10, 2023
Audit and Feedback to Surgery Interns and Residents on Prescribing Risk-Appropriate Venous Thromboembolism
Jonathan K Aboagye1, Elliott R Haut2, Michael B Streiff3
1Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
A web-based dashboard providing individualized feedback significantly improved venous thromboembolism (VTE) prophylaxis prescribing practices among general surgery trainees, achieving near-perfect compliance.
Area of Science:
- Medical Education
- Surgical Outcomes
- Health Informatics
Background:
- Venous thromboembolism (VTE) prophylaxis is crucial in general surgery.
- Optimizing prescribing practices among trainees is an ongoing challenge.
- Current feedback methods may have limited impact on adherence.
Purpose of the Study:
- To assess the effectiveness of emailed scorecards and web-based dashboards for feedback on VTE prophylaxis.
- To evaluate the impact of these interventions on general surgery residents' and interns' prescribing practices.
- To determine which feedback method leads to improved risk-appropriate VTE prophylaxis prescription.
Main Methods:
- Prospective cohort study at an urban academic medical center.
- Interventions included a scorecard, a wash-in period (no feedback), and a web-based dashboard.
- Monthly emails delivered feedback; trainees accessed dashboard data anytime.
Main Results:
- Resident compliance improved from 95.6% (scorecard) to 98.4% (wash-in and dashboard).
- Intern compliance improved from 91.5% to 96.4% between wash-in and dashboard periods.
- The web-based dashboard demonstrated superior or equivalent effectiveness compared to the scorecard.
Conclusions:
- Individualized performance feedback via a web-based dashboard significantly enhances VTE prophylaxis prescribing.
- This approach can lead to near-perfect adherence to risk-appropriate prophylaxis guidelines.
- Web-based dashboards represent an effective tool for medical education and quality improvement in surgical settings.
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