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Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial.
Sitzman, Thomas J; Tse, Raymond W; Allori, Alexander C; Fisher, David M; Samson, Thomas D; Beals, Stephen P; Matic, Damir B; Marcus, Jeffrey R; Grossoehme, Daniel H; Britto, Maria T.
Afiliación
  • Sitzman TJ; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Tse RW; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Allori AC; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Fisher DM; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Samson TD; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Beals SP; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Matic DB; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Marcus JR; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Grossoehme DH; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
  • Britto MT; From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Di
Plast Reconstr Surg ; 146(1): 144-153, 2020 07.
Article en En | MEDLINE | ID: mdl-32590658
ABSTRACT

BACKGROUND:

Improving surgeons' technical performance may reduce their frequency of postoperative complications. The authors conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons performing cleft palate repair, in advance of a future effectiveness trial.

METHODS:

A nonrandomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.

RESULTS:

Seven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4 percent (range, 0 to 10.5 percent). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9 percent at baseline and 0.0 percent following feedback (adjusted OR, 0.98; 95 percent CI, 0.44 to 2.17).

CONCLUSION:

Surgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Fisura del Paladar / Procedimientos de Cirugía Plástica / Fístula / Tutoría Tipo de estudio: Incidence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Año: 2020 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Fisura del Paladar / Procedimientos de Cirugía Plástica / Fístula / Tutoría Tipo de estudio: Incidence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Año: 2020 Tipo del documento: Article