Abstract
Introduction
Performance improvement (PI) programs are an educational tool to analyze clinical parameters taking the behavior and attitude of clinicians into account.1 The impact of this tool is not fully explored in orthopedic and trauma surgery. This educational research aimed to deliver an effective PI program to orthopedic trauma surgeons, neurosurgeons, and radiologists to improve communication and the use of MRI in spinal trauma.
Materials and Methods
Following a worldwide web session on MRI in spinal injuries to identify the clinical need for an educational intervention, a three-step PI process was defined and implemented over a 6-month period in a hospital department. Opportunities for improvement were identified by applying a 10-item quality checklist to 26 cases. Then a focused educational intervention was delivered to address identified gaps, and a set of 22 post-education cases was compared.
Results
A total of 26 cases collected before the educational intervention showed several areas for potential improvement. In only 5 of the 26 cases, a specific trauma mechanism or a possible inflammatory or malignant illness was mentioned by the surgeon, where such information may lead to a change in MRI sequence planning. In 23 cases, the radiologist did not believe that the communication led to a change of plan, although sequences other than usual were performed. The educational intervention outlined the data and suggested actions. Comparing the information transfer of the pre- and postinterventional data there was a significant improvement following the intervention (p = 0.0013). Following the intervention, the communication between surgeons and radiologists significantly influenced the sequences (p = 0.0152).
Conclusion
There are specific aspects that may be improved concerning communication between the surgeon and the radiologist. Our PI program was able to demonstrate a significant influence on the behavior and attitude of surgeons and radiologists. In the future, the impact on patient-related outcome parameters has to demonstrate the clinical influence of PI programs in the care of spine patients.
Martin C, Rüetschi U, Cunningham M. Design and implementation of performance improvement programs for orthopedic trauma surgeons. Presented at: AMEE Conference; 2013