Background: Perioperative medicine is a complexed area of hospitalist medicine, with many nuanced clinical management scenarios. At Froedtert and the Medical College of Wisconsin, Hospital medicine and perioperative medicine are two separate sections within the division of general internal medicine. The sections share some clinical services, including night coverage and sick (“jeopardy”) call. Perioperative medicine faculty perform the majority of consults and co-management for surgical patients, so hospitalists have less overall regular exposure to these patients and clinical topic areas.
Purpose: The goal of this project was to provide hospitalists with key points in perioperative medicine that affect patient outcomes and hospital efficiency.
Description: A short, targeted curriculum was developed for hospitalists that provided key points related to providing new perioperative consults and cross-coverage during off hours. The goal of the curriculum was to have a self-directed presentation that each hospitalist could complete in 30 minutes or less. Each slide contained a topic area with a few major key points. Slides were intended to be major overviews, without significant detail. Reference links were provided for those who wanted additional detail. All were focused on non-elective surgery. Topic areas included preoperative clinical care for patients undergoing non-elective surgery, postoperative cross-coverage issues, and systems topics (resources, procedures). Examples of covered topic areas were perioperative management of antiplatelet and anticoagulant therapy, echocardiography and stress test indications, key medication management, when to consult anesthesiology and transfusion indications. Final topics and related content were reviewed by two senior perioperative faculty members. A total of 20 topics were covered, with an average of 179 minutes spent by faculty completing the curriculum. A short pre- and post-test related to topics in the key points presentation was administered. A pilot project was undertaken from 07/2021 to 10/2021 to evaluate the feasibility and success of this project on a larger scale.A total of 68 faculty members received the curriculum, of which 13 completed the presentation, pre- and post- tests. Feedback regarding the quality of the topics and presentation was average 4.7 out of 5 possible points, ranging from 4.0-5.0. Faculty members were asked to rate their level of knowledge on the topic areas before and after completion of the curriculum on a 5-point Likert scale, with 5 being the best. The average pre-test score was 3.2 and the average post-test score was 4.0. Using a paired T test, the p value was < 0.001 (95% CI -1.177 to -0.685).
Conclusions: A power point presentation containing targeted perioperative key points for delivering clinical care appeared to improve hospitalists knowledge base in this pilot project. A larger scale sample is likely to achieve significant outcomes.