title: Decision support using anesthesia information management system records and accreditation council for graduate medical education case logs for resident operating room assignments.
abstract: Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. A Rhinos pilot was performed for 6 weeks on 2 clinical services. One hundred sixty-five requests were entered and used in OR assignment decisions by a single attending anesthesiologist. Each request consisted of a rank ordered list of up to 3 ORs. Residents had access to detailed information about these cases including surgeon and patient name, age, procedure type, and admission status. Success rates at matching resident requests were determined by comparing requests with AIMS records. Of the 165 requests, 87 first-choice matches (52.7%), 27 second-choice matches (16.4%), and 8 third-choice matches (4.8%) were made. Forty-three requests were unmatched (26.1%). Thirty-nine first-choice requests overlapped (23.6%). Full implementation followed on 8 clinical services for 8 weeks. Seven hundred fifty-four requests were reviewed by 15 attending anesthesiologists, with 339 first-choice matches (45.0%), 122 second-choice matches (16.2%), 55 third-choice matches (7.3%), and 238 unmatched (31.5%). There were 279 overlapping first-choice requests (37.0%). The overall combined match success rate was 69.4%. Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case-log data in decision support systems for informing resident OR assignments. Additional analysis will be necessary to assess the educational impact of these systems.
authors.affiliation: Department of Anesthesiology, 1301 Medical Center Drive, Suite 4648, The Vanderbilt Clinic, Nashville, TN 37212, USA. jonathan.p.wanderer@vanderbilt.edu
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Wanderer
authors.forename: Jonathan
authors.initials: J
authors.lastname: Charnin
authors.forename: William D
authors.initials: WD
authors.lastname: Driscoll
authors.forename: Michael T
authors.initials: MT
authors.lastname: Bailin
authors.forename: Keith
authors.initials: K
authors.lastname: Baker
mesh_terms: D000068:Accreditation / Q000592:standards*; D000761:Anesthesia Department, Hospital / Q000592:standards*; D000776:Anesthesiology / Q000193:education* / Q000592:standards*; D002983:Clinical Competence / Q000592:standards; D003661:Decision Support Techniques; D004503:Education, Medical, Graduate / Q000592:standards*; D005240:Feasibility Studies; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D009870:Operating Room Information Systems / Q000592:standards*; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D010562:Personnel Staffing and Scheduling Information Systems / Q000592:standards*; D010865:Pilot Projects; D015397:Program Evaluation; D012985:Software Design; D013997:Time Factors; D016526:Workload / Q000592:standards