HealthDay News — Providing clinical performance feedback to surgical residents regarding prescription of appropriate venous thromboembolism (VTE) prophylaxis improves performance, according to a study published in the Annals of Surgery.

Brandyn D. Lau, MPH, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a prospective cohort study to compare outcomes across 3 study periods: baseline, scorecard alone, and scorecard plus coaching. Data were included for all 49 general surgery residents and 2,420 surgical patients for whom residents wrote admission orders.

The researchers found that 89.4% of patients were prescribed appropriate VTE prophylaxis at baseline; only 45% of residents prescribed appropriate VTE prophylaxis for all patients. Appropriate VTE prescription increased significantly (to 95.4%) during the scorecard period (P < 0.001). Significantly more residents prescribed appropriate prophylaxis for every patient for the scorecard plus coaching period (78 versus 45%; P = 0.0017). In both intervention periods, preventable VTE was eliminated (0 versus 0.35%; P = 0.046). On the Accreditation Council for Graduate Medical Education resident survey, significantly more residents reported receiving data about practice habits after feedback was provided (87 versus 38%; P < 0.001).

“Providing personal clinical effectiveness feedback, including data and peer-to-peer coaching, improves resident performance, and results in a significant reduction in harm for patients,” the authors write.

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One author disclosed financial ties to the pharmaceutical industry; one author disclosed receiving royalties from the publishing industry.


Lau BD, Arnaoutakis GJ, Streiff MB, et al. Individualized Performance Feedback to Surgical Residents Improves Appropriate Venous Thromboembolism Prophylaxis Prescription and Reduces Potentially Preventable VTE: A Prospective Cohort Study. Ann Surg. 2015; doi:10.1097/SLA.0000000000001512.