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A921
October 18, 2010
9:00:00 AM - 11:00:00 AM
Room Hall B1-Area G
More Eyes on the Prize? The Effect of an Anesthesia Residency on Compliance with SCIP Metrics
  **   Steven Roth, M.D., Avery Tung, M.D.
Anesthesia and Critical Care, University of Chicago, Chicago, Illinois
Introduction: The Surgical Care Improvement Program (SCIP) is a Government sponsored strategy to introduce evidence-based appraoches into clinical care of patients undergoing anesthesia and surgery. Two SCIP metrics are under the direct influence of anesthesiologists: the perioperative continuation of beta blockers in patients chronically receiving beta blockers, and administration of antibiotics within 1 hour of surgical incision. We hypothesized that the presence of an anesthesia residency program would positively influence compliance with these metrics.

Methods: This study did not require IRB approval. We reviewed data from the Joint Commission on SCIP compliance for the 12 months ending in June 2009 (www.jointcommission.org). The dataset includes hospital name and location, number of eligible surgical patients, and rate of compliance, as well as comparison to national and state averages. We grouped compliance data from the five largest states (California, Texas, New York, Illinois, and Florida), and identified hospitals with an accredited anesthesia residency via the ACGME website (www.acgme.org). We then segregated hospitals according to the presence or absence of an anesthesia residency program, and computed compliance with both beta blocker and antibiotic metrics for each group. We used an unpaired t test (unequal sample, equal variance) to examine differences in compliance between hospitals with and without anesthesia residency programs.

Results: Compliance data for 834 hospitals were available from the Joint Commission database. Of these, 47 (5.6%) had accredited residency programs. For both SCIP measures, compliance was greater in hospitals with an anesthesia residency (90.8 ± 8.9% vs 89.3 ± 11% for beta blocker continuance, 95.7 ± 4.3% vs 93.4 ± 8.4% for antibiotic timing, p<0.05 for both). We found no correlation between size of state or number of programs per state and compliance with either measure.

Conclusions: We found that hospitals with an accredited anesthesia residency had better compliance with two SCIP measures (beta blocker continuance and antibiotic timing) than those without a residency program. Possible mechanisms for the effect we observed include a larger provider to patient ratio, greater awareness of evidence based quality measures, and differences in patient population. Further research may better identify factors associated with improved compliance with SCIP metrics.

From Proceedings of the 2010 Annual Meeting of the American Society Anesthesiologists.