A 16-question survey was administered to the surgical residents at a single general surgery residency program. A standardized signout using the mnemonic \"CUTS\" (Core problem, Updates, Things-to-do, Setbacks) was then implemented in the program. Residents retook the survey at 1, 3, and 6-month intervals to compare resident satisfaction on signout before and after the standardized signout implementation. The descriptive statistics of the survey were analyzed for trends over time, trends by resident training year, and for inferential statistics utilizing subscales.
The descriptive statistics showed that there was an overall trend towards greater resident satisfaction with signout over time with satisfaction increasing from 41.1% to 80% in the general resident cohort. While there were no statistically significant differences, subscale analysis demonstrated greatest trends for improved satisfaction with the CUTS signout model for the PGY1 and PGY5 classes. There was additionally an increased resident preparedness for overnight events and calls, with a 27% increase in perceived preparedness \"75% of the time\" and a 5.5% increase in perceived preparedness \"Always\". There was no difference in time spent on signout after the implementation of the model.
The surgical standardized signout model, CUTS, demonstrated that residents within a single program were more satisfied with signouts, had improved patient understanding and knowledge, and felt increased preparedness for overnight events on cross-covered patients. Further research is needed to determine the impact of the CUTS signout system on patient outcomes.
方法:在单一普外科住院医师计划中对手术住院医师进行了16个问题的调查。使用助记符“CUTS”(核心问题,更新,要做的事情,挫折)然后在程序中实现。居民每隔1个月、3个月和6个月重新进行调查,以比较标准化签出实施前后居民对签出的满意度。分析了调查的描述性统计量随时间的变化趋势,按住院医师培训年度划分的趋势,以及利用分量表进行推理统计。
结果:描述性统计显示,随着时间的推移,居民对引航的满意度总体上有提高的趋势,在普通居民队列中,满意度从41.1%提高到80%。虽然没有统计学上的显著差异,子量表分析显示了PGY1和PGY5类对CUTS引航模型满意度提高的最大趋势.此外,居民对过夜事件和电话的准备也有所增加,感知准备增加27%“75%的时间”,感知准备增加5.5%“总是”。实施该模型后,在签出上花费的时间没有差异。
结论:手术标准化引证模型,切割,证明了一个项目中的居民对签售更满意,提高了患者的理解和知识,并感到对交叉覆盖患者的过夜事件的准备工作有所增加。需要进一步的研究来确定CUTS引航系统对患者预后的影响。