title: A surgical team with focus on staff education in a community hospital improves outcomes, costs and patient satisfaction.
abstract: BACKGROUND
  Outcomes, decreased costs, and patient satisfaction are the driving forces of a successful surgical practice.
  
  
  METHODS
  A surgical team was assembled on October 1, 2010, and educational sessions were implemented. The outcomes and costs for patients who underwent laparoscopic fundoplication and Heller myotomy before and after October 1, 2010, were compared. A Press Ganey patient satisfaction survey was mailed to all patients.
  
  
  RESULTS
  There were 268 procedures (103 before and 165 after October 1, 2010): 64 laparoscopic fundoplications and Heller myotomies (23 before and 41 after). There were significant reductions in median operating time (185 minutes [interquartile range {IQR}, 155 to 257 minutes] vs 126 minutes [IQR, 113 to 147 minutes]; P = .001), length of stay (2.0 days [IQR, 2.0 to 4.0 days] vs 1.0 day [IQR, 1.0 to 2.5 days]; P = .05), operating room costs ($2,407 [IQR, $2,171 to $2,893] vs $2,147 [IQR, $1,942 to $2,345]; P = .004), and hospital room costs ($937 [IQR, $799 to $2,159] vs $556 [IQR, $484 to $937]; P = .044). The survey showed significant improvements in patients' experiences in communication with nurses (P = .025), pain management (P = .000), communication about medications (P = .037), and discharge instructions (P = .024).
  
  
  CONCLUSIONS
  Assembling a surgical team with focus on staff education has a significant impact on outcomes, costs, and patient satisfaction.
authors.affiliation: Memorial Hermann Southeast Esophageal Disease Center, 11800 Astoria Boulevard, Houston, TX 77089, USA. Electronic address: farzaneh.banki@uth.tmc.edu.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Banki
authors.forename: Kelly
authors.initials: K
authors.lastname: Ochoa
authors.forename: Mary E
authors.initials: ME
authors.lastname: Carrillo
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Leake
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Estrera
authors.forename: Kamal
authors.initials: K
authors.lastname: Khalil
authors.forename: Hazim J
authors.initials: HJ
authors.lastname: Safi
mesh_terms: D013502:General Surgery / Q000193:education*; D017721:Hospital Costs; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education*; D010348:Patient Care Team / Q000592:standards*; D017060:Patient Satisfaction; D011446:Prospective Studies; D013781:Texas
keywords: Costs; Outcomes; Patient satisfaction; Surgical education