Facilitation of Surgical Innovation : Is It Possible to Speed the Introduction of New Technology While Simultaneously Improving Patient Safety?
OBJECTIVE: To review efficiency metrics and patient safety data before and after implementation of a structured review process for surgical innovations.
SUMMARY BACKGROUND DATA: Surgical innovation ranges from minor incremental improvement to radical experimentation. Although innovation paradigms have been described, these are not widely adopted or enforced in the surgical community.
METHODS: A Continuous Quality Improvement Team (CQIT) of surgical quality officers and perioperative nurses was organized to perform structured reviews of proposed new surgical devices and procedures at a large quaternary cancer care center. The CQIT process was placed to precede an established Value Analysis Team business evaluation. Pre- and post-CQIT implementation metrics of approval process efficiency and patient safety data were compared. Seven novel procedures were also vetted by the CQIT.
RESULTS: Forty-six product requests were evaluated after CQIT implementation. Compared with 34 products evaluated prior to CQIT establishment, the total mean evaluation time decreased from 124 to 51 days (P= 0.007). For new devices requiring intraoperative trial, the time between product proposal and trial decreased from a mean of 260 to 99 days (P= 0.014). The rate of device-related complications in the pre-CQIT group was 10% compared with 0% post-CQIT. Two devices, which administratively bypassed CQIT review, had both minor and major complications, including a mortality. Five novel procedures approved by CQIT with simulation were performed without complications.
CONCLUSIONS: Using novel algorithms, the addition of a dedicated team of surgical quality officers to the surgical innovation evaluation process improved both the efficiency and the safety associated with introducing new devices and procedures into practice.
| Errataetall: |
CommentIn: Ann Surg. 2019 Dec;270(6):942-943. - PMID 31726618 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:270 |
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| Enthalten in: |
Annals of surgery - 270(2019), 6 vom: 01. Dez., Seite 937-941 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Marcus, Rebecca K [VerfasserIn] |
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| Anmerkungen: |
Date Completed 20.03.2020 Date Revised 13.12.2021 published: Print CommentIn: Ann Surg. 2019 Dec;270(6):942-943. - PMID 31726618 Citation Status MEDLINE |
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| doi: |
10.1097/SLA.0000000000003290 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM295678399 |
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| 500 | |a Date Revised 13.12.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Ann Surg. 2019 Dec;270(6):942-943. - PMID 31726618 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To review efficiency metrics and patient safety data before and after implementation of a structured review process for surgical innovations | ||
| 520 | |a SUMMARY BACKGROUND DATA: Surgical innovation ranges from minor incremental improvement to radical experimentation. Although innovation paradigms have been described, these are not widely adopted or enforced in the surgical community | ||
| 520 | |a METHODS: A Continuous Quality Improvement Team (CQIT) of surgical quality officers and perioperative nurses was organized to perform structured reviews of proposed new surgical devices and procedures at a large quaternary cancer care center. The CQIT process was placed to precede an established Value Analysis Team business evaluation. Pre- and post-CQIT implementation metrics of approval process efficiency and patient safety data were compared. Seven novel procedures were also vetted by the CQIT | ||
| 520 | |a RESULTS: Forty-six product requests were evaluated after CQIT implementation. Compared with 34 products evaluated prior to CQIT establishment, the total mean evaluation time decreased from 124 to 51 days (P= 0.007). For new devices requiring intraoperative trial, the time between product proposal and trial decreased from a mean of 260 to 99 days (P= 0.014). The rate of device-related complications in the pre-CQIT group was 10% compared with 0% post-CQIT. Two devices, which administratively bypassed CQIT review, had both minor and major complications, including a mortality. Five novel procedures approved by CQIT with simulation were performed without complications | ||
| 520 | |a CONCLUSIONS: Using novel algorithms, the addition of a dedicated team of surgical quality officers to the surgical innovation evaluation process improved both the efficiency and the safety associated with introducing new devices and procedures into practice | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
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| 700 | 1 | |a Caudle, Abigail S |e verfasserin |4 aut | |
| 700 | 1 | |a Weinberg, Jeffrey S |e verfasserin |4 aut | |
| 700 | 1 | |a Gidley, Paul W |e verfasserin |4 aut | |
| 700 | 1 | |a Skibber, John M |e verfasserin |4 aut | |
| 700 | 1 | |a Levenback, Charles F |e verfasserin |4 aut | |
| 700 | 1 | |a Swisher, Stephen G |e verfasserin |4 aut | |
| 700 | 1 | |a Aloia, Thomas A |e verfasserin |4 aut | |
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