The Positive Value of Rotation-Specific Guides for Resident Education and Patient Care: A Process Improvement Study

Introduction Providing high-quality cost-effective patient care requires knowledge of treatment protocols as well as an understanding of the institution's procedures, e.g., what orders to place and how to effectively place them. Disseminating rotation-specific evidence-based practice and institutional policies in a timely manner to medical residents rotating onto a service can be challenging. We determined, by root cause analysis, that a solution was to use a structured guide containing rotation-specific information. The purpose of this study was to evaluate the effectiveness of a rotation-specific pocket reference guide to distribute evidence-based and rotation-specific practice information to medical residents rotating through an Academic Vascular Surgery service and to evaluate this tool's ability to increase participants' perception of comfort and efficacy, all of which can be linked to high-quality and cost-effective patient care. Materials and methods We conducted a prospective study at the Detroit Medical Center, a Michigan-based level one trauma hospital, from November 2020 through February 2021. The inclusion criteria included medical residents that were on the Vascular Surgery rotation in the given time frame and that agreed to take a pre-/post-evaluation. The evaluation consisted of a quantitative test and a qualitative questionnaire. A t-test was used to analyze pre- and post-question score averages. Results There was a significant improvement in quantifiable knowledge as participants' scores increased on post-rotation testing scoring with an average of 88% post-rotation compared to 58% pre-rotation (p<0.01). Ancillary staff reported a decrease in incorrect orders, substantiating increased efficacy and inferring cost-effectiveness. Individuals evaluated post-rotation indicated the usefulness of the guide as an educational tool for the dissemination of evidence-based practice (p<0.01) and increased confidence in placing preoperative orders (p<0.01). This, coupled with a post-rotation increase in preference toward a written learning style, led to the additional conclusion that this guide would be a beneficial preparatory tool for future board examinations.  Conclusions This study supports the implementation of rotation guides as a preparatory source used to improve the dissemination of rotation-specific information, which should increase resident efficacy, improve cost-effectiveness, and potentially improve future board examination scores. We recommend a chart review of specified metrics, e.g., incorrect order frequency and related operative delays, to show to what extent the cost-effectiveness and increase in high-quality patient care manifested.