Improving the quality of general surgery continuous quality improvement rounds: lessons learned from British Columbia

Continuous quality improvement rounds (CQIRs) play an important role in medical education, quality assurance, and accreditation in Canadian hospitals. This study aimed to establish a more thorough understanding of their specific application and perceived value in general surgery departments within hospitals in British Columbia (BC), Canada. A 27-item (and one additional optional item) cross-sectional survey was conducted between August-December 2023 amongst general surgery department heads across BC hospitals, with the goal of obtaining information on CQIR logistics such as scheduling, format, and content, as well as surgeons' subjective assessments of impact on quality improvement, educational value, and barriers to participation. Thirteen complete responses representing surgical departments across the province were qualitatively analyzed. Most reported monthly or every 4 months CQIR meetings, lasting at least one hour, with strong attendance by attending surgeons. Noted areas for improvement included the absence of specific inclusion criteria, the need for standardized error classification, and lack of post-CQIR engagement for learning assessment. Respondents expressed satisfaction with CQIR effectiveness but communicated a desire for more in-person meetings and increased structure. CQIRs in BC are effective but occur less frequently than is ideal for medical education and quality improvement. This study suggests an increase in meeting frequency and organization in case selection and analysis may enhance the delivery and application of key learning objectives. Future research in this area is needed.