Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;12(3):479-483.
doi: 10.1055/s-0041-1730323. Epub 2021 May 26.

Improving ACGME Compliance for Obstetric Anesthesiology Fellows Using an Automated Email Notification System

Affiliations

Improving ACGME Compliance for Obstetric Anesthesiology Fellows Using an Automated Email Notification System

Holly B Ende et al. Appl Clin Inform. 2021 May.

Abstract

Background: The Accreditation Council for Graduate Medical Education establishes minimum case requirements for trainees. In the subspecialty of obstetric anesthesiology, requirements for fellow participation in nonobstetric antenatal procedures pose a particular challenge due to the physical location remote from labor and delivery and frequent last-minute scheduling.

Objectives: In response to this challenge, we implemented an informatics-based notification system, with the aim of increasing fellow participation in nonobstetric antenatal surgeries.

Methods: In December 2014 an automated email notification system to inform obstetric anesthesiology fellows of scheduled nonobstetric surgeries in pregnant patients was initiated. Cases were identified via daily automated query of the preoperative evaluation database looking for structured documentation of current pregnancy. Information on flagged cases including patient medical record number, operating room location, and date and time of procedure were communicated to fellows via automated email daily. Median fellow participation in nonobstetric antenatal procedures per quarter before and after implementation were compared using an exact Wilcoxon-Mann-Whitney test due to low baseline absolute counts. The fraction of antenatal cases representing nonobstetric procedures completed by fellows before and after implementation was compared using a Fisher's exact test.

Results: The number of nonobstetric antenatal cases logged by fellows per quarter increased significantly following implementation, from median 0[0,1] to 3[1,6] cases/quarter (p = 0.007). Additionally, nonobstetric antenatal cases completed by fellows as a percentage of total antenatal cases completed increased from 14% in preimplementation years to 52% in postimplementation years (p < 0.001).

Conclusion: Through an automated email system to identify nonobstetric antenatal procedures in pregnant patients, we were able to increase the number of these cases completed by fellows during 3 years following implementation.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Total number of obstetric and nonobstetric antenatal surgery cases logged by obstetric anesthesiology fellows in each academic year from July 2013 through June 2018. Arrow indicates timing of intervention, with automated email system initiated in December 2014, halfway through academic year 2014 to 2015. Obstetric antenatal cases include cervical cerclage, external cephalic version, and fetal surgery cases.

Similar articles

References

    1. Education ACfGM Accessed December 8, 2020 at:https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements
    1. Huang S Y, Lo P H, Liu W M. Outcomes after nonobstetric surgery in pregnant patients: a nationwide study. Mayo Clin Proc. 2016;91(09):1166–1172. - PubMed
    1. Bonnet M P. Sedation and anaesthesia for non-obstetric surgery. Anaesth Crit Care Pain Med. 2016;35 01:S35–S41. - PubMed
    1. Dalal A K, Schaffer A, Gershanik E F. The impact of automated notification on follow-up of actionable tests pending at discharge: a cluster-randomized controlled trial. J Gen Intern Med. 2018;33(07):1043–1051. - PMC - PubMed
    1. Weingart S N, Yaghi O, Barnhart L. Preventing diagnostic errors in ambulatory care: an electronic notification tool for incomplete radiology tests. Appl Clin Inform. 2020;11(02):276–285. - PMC - PubMed