Browsing by Author "Stulberg, Jonah J."

Now showing 1 - 4 of 4
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    A Mixed-Methods Evaluation of Clinician Education Modules on Reducing Surgical Opioid Prescribing
    (Elsevier, 2021) Shallcross, Meagan L.; Stulberg, Jonah J.; Schäfer, Willemijn L. A.; Buckley, Barbara A.; Huang, Reiping; Bilimoria, Karl Y.; Johnson, Julie K.; Surgery, School of Medicine
    Background: In this study, we developed online interactive clinician education modules highlighting best practices to minimize opioid prescribing at discharge after surgery. The modules were implemented as part of a multicomponent quality improvement initiative across a six-hospital health system. This article describes the development and evaluation of this educational intervention. Materials and methods: Clinician education modules targeting surgical prescribers, nurses, and pharmacists were developed and implemented by an interdisciplinary team. Clinicians were invited to participate in an evaluation survey after completing the modules. Survey items assessed clinicians' rating of the module and intention to change clinical practice because of the module. Quantitative and qualitative survey responses were analyzed by the study team. Results: A total of 2119 clinicians completed the module and 1831 of these clinicians (86.4%) completed the survey. Of clinicians completing the survey, 65.6% reported that they intend to change clinical practice after completing the module. Intended changes were related to increased knowledge and awareness, provider empowerment, opioid prescribing practices, nonopioid prescribing practices, and patient education. Many clinicians who indicated they do not intend to change practice reported that their clinical practices were already in line with module recommendations. Some clinicians did not perceive the module to be relevant to their role. Conclusions: Module completion was associated with the intention to improve clinical practice in areas related to provider empowerment, opioid prescribing, nonopioid prescribing, and patient education. Evaluation data will inform future module improvements. There is an opportunity to ensure that all clinicians, including those who are not prescribers, recognize their role in opioid stewardship.
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    An Evaluation of Peer-Rated Surgical Skill and its Relationship With Detrusor Muscle Sampling in Transurethral Resection of Bladder Tumor
    (Elsevier, 2022) Pham, Minh N.; Ko, Oliver S.; Huang, Reiping; Vo, Amanda X.; Tsai, Kyle P.; Lai, Jeremy D.; Hudnall, Matthew T.; Halpern, Joshua A.; Meeks, Joshua J.; Benson, Jonas; Soares, Ricardo; Kim, Ronald; Bilimoria, Karl Y.; Stulberg, Jonah J.; Auffenberg, Gregory B.; Surgery, School of Medicine
    Objective: To assess the reliability of peer-review of TURBT videos as a means to evaluate surgeon skill and its relationship to detrusor sampling. Methods: Urologists from an academic health system submitted TURBT videos in 2019. Ten blinded peers evaluated each surgeon's performance using a 10-item scoring instrument to quantify surgeon skill. Normalized composite skill scores for each surgeon were calculated using peer ratings. For surgeons submitting videos, we retrospectively reviewed all TURBT pathology results (2018-2019) to assess surgeon-specific detrusor sampling. A hierarchical logistic regression model was fit to evaluate the association between skill and detrusor sampling, adjusting for patient and surgeon factors. Results: Surgeon skill scores and detrusor sampling rates were determined for 13 surgeons performing 245 TURBTs. Skill scores varied from -6.0 to 5.1 [mean: 0; standard deviation (SD): 2.40]. Muscle was sampled in 72% of cases, varying considerably across surgeons (mean: 64.5%; SD: 30.7%). Among 8 surgeons performing >5 TURBTs during the study period, adjusted detrusor sampling rate was associated with sending separate deep specimens (odds ratio [OR]: 1.97; 95% confidence interval [CI]: 1.02-3.81, P = .045) but not skill (OR: 0.81; 95% CI: 0.57-1.17, P = .191). Conclusion: Surgeon skill was not associated with detrusor sampling, suggesting there may be other drivers of variability of detrusor sampling in TURBT.
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    Association Between Surgical Technical Skill and Long-term Survival for Colon Cancer
    (American Medical Association, 2021) Brajcich, Brian C.; Stulberg, Jonah J.; Palis, Bryan E.; Chung, Jeanette W.; Huang, Reiping; Nelson, Heidi; Bilimoria, Karl Y.; Surgery, School of Medicine
    This cohort study examines the association between surgical technical skill and overall survival following colectomy for colon cancer.
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    Development of the Illinois Surgical Quality Improvement Collaborative (ISQIC): Implementing 21 Components to Catalyze Statewide Improvement in Surgical Care
    (Wolters Kluwer, 2023) Bilimoria, Karl Y.; McGee, Michael F.; Williams, Mark V.; Johnson, Julie K.; Halverson, Amy L.; O'Leary, Kevin J.; Farrell, Paula; Thomas, Juliana; Love, Remi; Kreutzer, Lindsey; Dahlke, Allison R.; D'Orazio, Brianna; Reinhart, Steven; Dienes, Katelyn; Schumacher, Mark; Shan, Ying; Quinn, Christopher; Prachand, Vivek N.; Sullivan, Susan; Cradock, Kimberly A.; Boyd, Kelsi; Hopkinson, William; Fairman, Colleen; Odell, David; Stulberg, Jonah J.; Barnard, Cindy; Holl, Jane; Merkow, Ryan P.; Yang, Anthony D.; Surgery, School of Medicine
    Introduction: In 2014, 56 Illinois hospitals came together to form a unique learning collaborative, the Illinois Surgical Quality Improvement Collaborative (ISQIC). Our objectives are to provide an overview of the first three years of ISQIC focused on (1) how the collaborative was formed and funded, (2) the 21 strategies implemented to support quality improvement (QI), (3) collaborative sustainment, and (4) how the collaborative acts as a platform for innovative QI research. Methods: ISQIC includes 21 components to facilitate QI that target the hospital, the surgical QI team, and the peri-operative microsystem. The components were developed from available evidence, a detailed needs assessment of the hospitals, reviewing experiences from prior surgical and non-surgical QI Collaboratives, and interviews with QI experts. The components comprise 5 domains: guided implementation (e.g., mentors, coaches, statewide QI projects), education (e.g., process improvement (PI) curriculum), hospital- and surgeon-level comparative performance reports (e.g., process, outcomes, costs), networking (e.g., forums to share QI experiences and best practices), and funding (e.g., for the overall program, pilot grants, and bonus payments for improvement). Results: Through implementation of the 21 novel ISQIC components, hospitals were equipped to use their data to successfully implement QI initiatives and improve care. Formal (QI/PI) training, mentoring, and coaching were undertaken by the hospitals as they worked to implement solutions. Hospitals received funding for the program and were able to work together on statewide quality initiatives. Lessons learned at one hospital were shared with all participating hospitals through conferences, webinars, and toolkits to facilitate learning from each other with a common goal of making care better and safer for the surgical patient in Illinois. Over the first three years, surgical outcomes improved in Illinois. Discussion: The first three years of ISQIC improved care for surgical patients across Illinois and allowed hospitals to see the value of participating in a surgical QI learning collaborative without having to make the initial financial investment themselves. Given the strong support and buy-in from the hospitals, ISQIC has continued beyond the initial three years and continues to support QI across Illinois hospitals.