A solution to the problem of undictated operative reports by residents.
The objective of this study was to reduce the number of operative reports assigned to the surgical residents but not dictated within 48 hours by 80% within 6 months.
A before-after trial was conducted in a teaching hospital (part of a major academic medical center) in an urban setting, of a complex intervention based on a theoretical framework for behavioral change.
Data were collected for more than 6 months before the intervention, and then in three separate time periods during the next 18 months.
The intervention, lasting 41 weeks, and directed specifically at undictated operative reports, comprised the following : educational sessions, posting of residents'names with delinquency rates, attending/resident interactions, telephone reminders, rewards, and punishments.
The population studied comprised every resident who rotated through the general surgery service over a 2-year period 1995 to 1997.
The mean (±SD) number of undictated operative reports declined progressively from 72 (±8.3) to 6 (±2.6).
This 92% reduction was statistically significant (P<0.00005).
The mean number of undictated discharge summaries declined progressively from 54 (±11.2) to 13 (±8.1).
This 76% reduction was also statistically significant (P<0.00005).
There was a close correlation between the operative reports and the discharge summaries (r=0.82). (...)
Mots-clés Pascal : Etats Unis, Amérique du Nord, Amérique, Homme, Médecine, Médecin, Résident, Etude statistique, Centre hospitalier universitaire, Compte rendu, Intervention, Performance, Organisation hospitalière
Mots-clés Pascal anglais : United States, North America, America, Human, Medicine, Physician, Resident, Statistical study, Teaching hospital, Report, Operation, Performance, Hospital organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0071938
Code Inist : 002B30A05. Création : 31/05/1999.