Coaching Intervention to Improve Technical Skill in Surgery Each year in this country more than 150,000 patients undergoing major inpatient surgery die, and many more suffer serious complications leading to major long term morbidity. These important outcomes vary widely across hospitals and surgeons, suggesting large opportunities for improvement. While most improvement efforts have focused on general aspects of perioperative care, emerging evidence suggests that the most important strategy for reducing adverse outcomes of surgery may be to improve the proficiency of the operating surgeon. In this context, we will build on our prior work evaluating technical quality in the Michigan Bariatric Surgery Collaborative (MBSC) to implement a statewide skill development intervention. The MBSC is the perfect laboratory for such a study, with the existing infrastructure to measure technical quality in place, a clinical registry with outcomes data for more than 40,000 consecutive bariatric surgery procedures, and a collaborative network of 70 surgeons from 35 hospitals who have a track-record of participating in both the rating of technical skills and in population-based improvement efforts.
Our specific aims are to develop a coaching intervention to improve technical skill and to evaluate its impact on surgical skills and clinical outcomes. Thi study will be highly innovative as the first large-scale study to apply coaching to improve technical skills among practicing surgeons. Results from this study will have immediate impact on surgeons, policymakers, and patients in need of surgery. Surgeons can build on this work to further augment large-scale quality improvement programs to focus on improving technical skill. Policy makers could develop similar programs and encourage surgeons to participate in them to achieve accreditation or board-certification. Ultimately, patients will be the beneficiaries of thi research as their surgeons become more skilled and they suffer fewer postoperative complications.

Public Health Relevance

Each year in this country more than 150,000 patients undergoing major inpatient surgery die, and many more suffer serious complications leading to major long term morbidity. Emerging evidence suggests that the most important strategy for reducing adverse outcomes of surgery may be to improve the proficiency of the operating surgeon. In this project we will build on our prior work evaluating technical quality in the Michigan Bariatric Surgery Collaborative to develop and implement a peer-coaching intervention and to evaluate its impacts on surgical skills and clinical outcomes. This study will be highly innovative as the first large-scale study to apply coaching to improve technical skills among practicing surgeons with important impacts on surgeons, policymakers, and patients in need of surgery.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
1R01DK101423-01
Application #
8671870
Study Section
Health Services Organization and Delivery Study Section (HSOD)
Program Officer
Horlick, Mary
Project Start
2014-05-01
Project End
2019-04-30
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
1
Fiscal Year
2014
Total Cost
$439,711
Indirect Cost
$119,181
Name
University of Michigan Ann Arbor
Department
Surgery
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Shubeck, Sarah P; Kanters, Arielle E; Sandhu, Gurjit et al. (2018) Dynamics within peer-to-peer surgical coaching relationships: Early evidence from the Michigan Bariatric Surgical Collaborative. Surgery 164:185-188
Kanters, Arielle E; Shubeck, Sarah P; Sandhu, Gurjit et al. (2018) Justifying our decisions about surgical technique: Evidence from coaching conversations. Surgery 164:561-565
Ibrahim, Andrew M; Dimick, Justin B; Joseph, Anjali (2017) Building a Better Operating Room: Views from Surgery and Architecture. Ann Surg 265:34-36
Grenda, Tyler R; Pradarelli, Jason C; Dimick, Justin B (2016) Using Surgical Video to Improve Technique and Skill. Ann Surg 264:32-3
Pradarelli, Jason C; Varban, Oliver A; Ghaferi, Amir A et al. (2016) Hospital variation in perioperative complications for laparoscopic sleeve gastrectomy in Michigan. Surgery 159:1113-20
Varban, Oliver A; Greenberg, Caprice C; Schram, Jon et al. (2016) Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another? Surgery 160:1172-1181
Pradarelli, Jason C; Jaffe, Gregory A; Lemak, Christy Harris et al. (2016) A leadership development program for surgeons: First-year participant evaluation. Surgery 160:255-63
Scally, Christopher P; Varban, Oliver A; Carlin, Arthur M et al. (2016) Video Ratings of Surgical Skill and Late Outcomes of Bariatric Surgery. JAMA Surg 151:e160428
Greenberg, Caprice C; Dombrowski, Janet; Dimick, Justin B (2016) Video-Based Surgical Coaching: An Emerging Approach to Performance Improvement. JAMA Surg 151:282-3
Jaffe, Gregory A; Pradarelli, Jason C; Lemak, Christy Harris et al. (2016) Designing a leadership development program for surgeons. J Surg Res 200:53-8

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