The Development of an Automated Method of Monitoring Surgeon Performance at an Academic Teaching Hospital

• Main Author: Chan, Beverley
• Language: en
• Published: 2014
• Subjects: Monitoring method; Colorectal surgery; CUSUM; VLAD; Funnel plot
• Online Access: http://hdl.handle.net/10393/30713

In this thesis, I chose to identify and evaluate different monitoring methods on surgeon specific outcomes in colorectal surgery. An initial literature search identified different methods that were applied to a cohort of colorectal patients operated on by general surgeons using an electronic hospital database. Surgeon specific complications were validated with a chart review. General surgeons at The Ottawa Hospital were surveyed on their opinions regarding monitoring outcomes. We can conclude that different methods may be needed as they are dependent heavily on specified target limits. With our derived cohort, we had adequate risk adjustment using a modified Escobar model for 30 day mortality and morbidity. These complications were derived from electronic algorithms and had excellent specificity and sensitivity. General surgeons at The Ottawa Hospital have different opinions regarding monitoring their outcomes and surgeon engagement is necessary to make monitoring fruitful for patients, public, hospital administration, and surgeons.