Trang Karen, Pierce Logan, Wick Elizabeth C, Vu Lan, Dicker Rochelle, Boeck Marissa A, Garber Kent, Hirose Kenzo
Department of Surgery, University of California San Francisco, San Francisco, California.
Division of Hospital Medicine, University of California San Francisco, San Francisco, California.
J Surg Educ. 2025 Feb;82(2):103342. doi: 10.1016/j.jsurg.2024.103342. Epub 2024 Dec 7.
To advance surgical education priorities by using electronic health record (EHR) reporting and data visualization on an Acute Care Surgery (ACS).
Operational data from the EHR for the ACS service was displayed on an ACS dashboard using Tableau software. This data included new ACS consults (reason for consult, consult note author - attending surgeon and resident) and operations generated by those consults (type of operation, primary attending surgeon, and assisting resident). All surgeons on the service were included on the dashboard. In collaboration with service and educational leaders, the dashboard was used to address two deficiencies. First, to reduce the administrative burden for residents on ACS service, the new dashboard replaced manually generated weekly consult and operative case lists. Second, as a part of a pilot program to enable faculty assessment of residents' Entrustable Professional Activities (EPAs) regarding pre-operative evaluation of acute surgical conditions, all faculty on the ACS service had access to the dashboard and received weekly reminders at the end of their service week. To assess the impact of the dashboard on these two education outcomes, resident surveys were used to determine average time spent on weekly consult and operative lists, and the number of EPA assessments completed were compared before, during, and after the pilot program.
Academic quaternary care hospital with a general surgery residency program comprising 50 clinically active residents.
Residents and faculty who rotated on the ACS service during the study period.
The dashboard was made available to all faculty on the ACS service and automatically emailed on Saturdays. The dashboard reduced weekly resident administrative work by an average of 60 (range 30-360) minutes per week by obviating the need for manual list creation. Completed perioperative/nonoperative EPA assessments increased from zero to 5.3/month during the pilot period and continued at 2.3/month in the 3 months after the pilot ended.
The ACS dashboard reduced resident workload and enhanced EPA assessment. More opportunities to align resident education with EHR operational tools are likely if surgical education specialists collaborate with healthcare system and/or informatics leadership. When possible, advances in healthcare system technology should also be designed to promote training and education.
通过在急性护理外科（ACS）中使用电子健康记录（EHR）报告和数据可视化来推进外科教育重点。
使用Tableau软件将ACS服务的EHR中的操作数据显示在ACS仪表板上。该数据包括新的ACS会诊（会诊原因、会诊记录作者——主治外科医生和住院医生）以及由这些会诊产生的手术（手术类型、主刀主治外科医生和协助的住院医生）。该服务的所有外科医生都被纳入仪表板。与服务和教育负责人合作，该仪表板用于解决两个不足之处。首先，为了减轻ACS服务住院医生的行政负担，新的仪表板取代了手动生成的每周会诊和手术病例清单。其次，作为一项试点计划的一部分，为了使教员能够评估住院医生在急性外科疾病术前评估方面的可托付专业活动（EPA），ACS服务的所有教员都可以访问该仪表板，并在其服务周结束时每周收到提醒。为了评估仪表板对这两个教育成果的影响，通过住院医生调查来确定每周花在会诊和手术清单上的平均时间，并比较试点计划之前、期间和之后完成的EPA评估数量。
一家学术性四级护理医院，有一个普通外科住院医师项目，包括50名临床活跃的住院医生。
研究期间在ACS服务部门轮转的住院医生和教员。
该仪表板可供ACS服务的所有教员使用，并在周六自动通过电子邮件发送。该仪表板通过消除手动创建清单的需求，将住院医生每周的行政工作平均减少了60（范围为30 - 360）分钟。在试点期间，完成的围手术期/非手术期EPA评估从零增加到每月5.3次，试点结束后的3个月中继续保持在每月2.3次。
ACS仪表板减轻了住院医生的工作量并加强了EPA评估。如果外科教育专家与医疗保健系统和/或信息学领导层合作，可能会有更多机会使住院医生教育与EHR操作工具保持一致。在可能的情况下，医疗保健系统技术的进步也应设计用于促进培训和教育。
