Development of Tool for Case Submission and Review as Foundation for Department Patient Safety/Quality Improvement Program
Abstract
Objective: Describe creation and implementation of secure case collection tool for the foundation of otolaryngology department Patient Safety/Quality Improvement (PSQI) program. Describe how tool decreased burden while fulfilling stakeholders’ reporting requirements.
Methods: Incorporation of elements of required reports into online tool, facilitating improved case submission for Morbidity and
Mortality conference (M&M) review. Reviewer commentary and conference discussion notes are recorded within the project. Regular reports tailored to each stakeholder were designed. Results: During first 8 months of implementation, 83 cases were submitted–5250 surgical procedures were performed by our department in that period—compared to 75 cases submitted via prior system in a same time period the year before (6930 surgical procedures performed). Elements of routine reports for interdepartmental use and external stakeholder requirements determined and reported. Discussion: Preliminary description of secure online tool with a single platform serving multiple stakeholders with unique reporting elements. This presents an opportunity to reduce the burden of essential administrative tasks while providing a reliable PSQI repository. Future metrics for ongoing evaluation will be identified and incorporated. Case submissions were maintained through a period of altered clinical activity (SARS-CoV-2 pandemic). Implications for Practice: This tool will allow our department to review cases for our required M&M with improved efficiency and efficacy, while supporting our PSQI program and generate necessary reports to stakeholders. Reduction of electronic task burden may reduce risk of physician burnout. Facilitating implementation of essential and required PSQI efforts will strengthen our curriculum and clinical work.
References
Kohn ALT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC; US: National Academies Press; 2000.
Sacks GD, Lawson EH, Tillou A. Morbidity and Mortality Conference 2.0. Ann Surg. 2015;262(2):228–237.
Shanafelt TD, Dyrbye LN, Sinsky C. Relationship between Clerical Burden and Characteristics of the Electronic Environment with Physician Burnout and Professional Satisfaction. Mayo Clin Proc. 2016;91(7):836–884.
Shanafelt TD, Hasan O, Dyrbye LN. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between. Mayo Clin Proc. 2011;90(12):1600–1613.
West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516–529.
Rosenfeld RM, Shiffman RN, Robertson P. Clinical Practice Guideline Development Manual, and Third Edition: a quality-driven approach for translating evidence into action Otolaryngol Head Neck Surg 2013 Jan; 148(1 Suppl):S1-55.
Kim MJ, Fleming FJ, Peters JH. Improvement in educational effectiveness of morbidity and mortality conferences with structured presentation and analysis of complications. J Surg Educ. 2010;67(6):400–405.
Baugh RF, Archer SM, Mitchell RB. Clinical practice guideline: tonsillectomy in children. Otolaryngology Head Neck Surg. 2011;144(1):1–30.
Vila PM, Lewis S, Cunningham G; 2017.
Dindo D, Demartines N, Clavien P. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–218.
Saint Louis University, School of Medicine, Office of the General Counsel. [cited 2020 October 27, 2020]; Available from: https://www.slu. edu/general-counsel/legal-services/index.php.
United States Department of Health and Human Services. Health Information Privacy. 2020.
Brenner MJ, Chang C, Boss, Ef. Patient Safety/Quality Improvement Primer, Part I: What PS/QI Means to Your Otolaryngology Practice. Otolaryngol Head Neck Surg. 2018;159(1):3–10.
Scott DR, Weimer M, English C. A novel approach to increase residents’ involvement in reporting adverse events. Acad Med. 2011;86(6):742–748.
Milch CE, Salem DN, Pauker SG. Voluntary electronic reporting of medical errors and adverse events. An analysis of 92,547 reports from 26 acute care hospitals. J Gen Intern Med. 2006;21(2):165–70.
American College of Surgeons Verified Children’s Surgery Centers. 2020 [cited 2020 October 27, 2020]; Available from: https://w ww.facs.org/quality-programs/childrens-surger y/childrens-surgery-verification/centers.
Rathi VK, Naunheim MR, Varvares MA, et al. The Merit-based Incentive Payment System (MIPS): A Primer for Otolaryngologists. Otolaryngol Head Neck Surg 2018 Sep;159(3):410-413.
