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© 2021. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background: Of the 150,000 patients annually undergoing coronary artery bypass grafting, 35% develop complications that increase mortality 5 fold and expenditure by 50%. Differences in patient risk and operative approach explain only 2% of hospital variations in some complications. The intraoperative phase remains understudied as a source of variation, despite its complexity and amenability to improvement.

Objective: The objectives of this study are to (1) investigate the relationship between peer assessments of intraoperative technical skills and nontechnical practices with risk-adjusted complication rates and (2) evaluate the feasibility of using computer-based metrics to automate the assessment of important intraoperative technical skills and nontechnical practices.

Methods: This multicenter study will use video recording, established peer assessment tools, electronic health record data, registry data, and a high-dimensional computer vision approach to (1) investigate the relationship between peer assessments of surgeon technical skills and variability in risk-adjusted patient adverse events; (2) investigate the relationship between peer assessments of intraoperative team-based nontechnical practices and variability in risk-adjusted patient adverse events; and (3) use quantitative and qualitative methods to explore the feasibility of using objective, data-driven, computer-based assessments to automate the measurement of important intraoperative determinants of risk-adjusted patient adverse events.

Results: The project has been funded by the National Heart, Lung and Blood Institute in 2019 (R01HL146619). Preliminary Institutional Review Board review has been completed at the University of Michigan by the Institutional Review Boards of the University of Michigan Medical School.

Conclusions: We anticipate that this project will substantially increase our ability to assess determinants of variation in complication rates by specifically studying a surgeon’s technical skills and operating room team member nontechnical practices. These findings may provide effective targets for future trials or quality improvement initiatives to enhance the quality and safety of cardiac surgical patient care.

International Registered Report Identifier (IRRID): PRR1-10.2196/22536

Details

Title
Novel Assessments of Technical and Nontechnical Cardiac Surgery Quality: Protocol for a Mixed Methods Study
Author
Likosky, Donald  VIAFID ORCID Logo  ; Yule, Steven J  VIAFID ORCID Logo  ; Mathis, Michael R  VIAFID ORCID Logo  ; Dias, Roger D  VIAFID ORCID Logo  ; Corso, Jason J  VIAFID ORCID Logo  ; Zhang, Min  VIAFID ORCID Logo  ; Krein, Sarah L  VIAFID ORCID Logo  ; Caldwell, Matthew D  VIAFID ORCID Logo  ; Nathan, Louis  VIAFID ORCID Logo  ; Janda, Allison M  VIAFID ORCID Logo  ; Shah, Nirav J  VIAFID ORCID Logo  ; Pagani, Francis D  VIAFID ORCID Logo  ; Stakich-Alpirez, Korana  VIAFID ORCID Logo  ; Manojlovich, Milisa M  VIAFID ORCID Logo 
Section
Participatory Research Protocols and Proposals
Publication year
2021
Publication date
Jan 2021
Publisher
JMIR Publications
e-ISSN
19290748
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2508598516
Copyright
© 2021. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.