Page 5 - CUA2018 Abstracts - Miscellaneous/Other

Poster session 2: Education/Practice Management

MP–2.4 to the survey and of 115 surveys with this additional question, 86% of
Development and initial validation of a low–cost ultrasound– PCPs stated that the educational value of the consult was 4/5. Only 2%
compatible suprapubic catheter insertion training simulator reflected that there was no use of the eConsult to either the patient or PCP.
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Yuding (Ding) Wang , Udi Blankstein , Jen Hoogenes , Ali Al–Hashimi , Conclusions: We show that programs such as the Champlain BASE eCon-
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Edward Matsumoto 1 sult service allow for constant feedback to surgeons in regards to the
1 Department of Surgery, Division of Urology, McMaster University, quality of care as perceived by their PCP counterparts. This allows ongoing
Hamilton, ON, Canada professional development for surgeons throughout their career, and an
Introduction: Bedside suprapubic catheterization (SPC) is a fundamental opportunity for reflection on their practice methods.
skill required of all urology trainees. Ultrasound guidance during SPC Reference:
insertion can minimize complications, and its use is recommended in 1. Lockyer J, Violato C, Fidler H. Likelihood of change: A study assess-
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clinical practice guidelines. However, a lack of affordable simulation ing surgeon use of multisource feedback data. Teach Learn Med
models and the unpredictability of bedside SPCs make learning this pro- 2003;15:168–74. https://doi.org/10.1207/S15328015TLM1503_04
cedure difficult for trainees. We developed and initially validated a low–
cost ultrasound–compatible SPC simulation model that allows trainees MP–2.6
to safely and deliberately practice the task while acquiring skills that are Utilization and impact of an ambulatory urology care centre
transferable to bedside SPCs. in Saskatchewan
Methods: The SPC simulator consists of seven components (Table 1; avail- Kirsten Jewitt , Trustin Domes 2
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able at https://cua.guide/). Seven staff urologists and four interventional 1 College of Medicine, University of Saskatchewan, Saskatoon, SK,
radiologists conducted a SPC using the model with ultrasound guidance Canada; Department of Surgery, University of Saskatchewan, Saskatoon,
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(Figs. 1, 2). To assess for face and content validity, each participant rated SK, Canada
the model (using a five–point Likert scale) on three domains: anatomic Introduction: Since 2013, the Urology Centre of Health (UCH) in
realism, usefulness as a training tool, and overall reaction. Saskatoon has provided consolidated ambulatory urological services with
Results: Participants were in practice for an average of 10 years (range the goal of improving the quality and efficiency of care. A program evalu-
2–23), and the median number of SPCs performed was 50. For the ation of the UCH was conducted in the summer of 2017 to evaluate
domains, anatomic realism scored a mean of 4.1 (mean of 4.0 for sono- the utilization and impact of the UCH, including any impact on acute
graphic realism). Usefulness as a training tool scored a mean of 4.3, and urological visits to Saskatoon’s emergency departments (ED).
the mean for overall reaction was 4.4. Participants strongly agreed that Methods: The logic model for program evaluation was used as a frame-
the model should be incorporated into urology residency (mean 4.4), the work to analyze program inputs, processes, outputs, and outcomes. Patient
skills are transferable to patients (mean 4.3), and its use would improve satisfaction (n=106) was assessed via surveys. Patient volume and treat-
trainee confidence (mean 4.6). The cost of the model is approximately ment data was extracted from an electronic health records database and
$48 CAD, and can be used multiple times during one session. patient wait time data was extracted from electronic medical records.
Conclusions: This novel, low–cost, easily reproducible, ultrasound–com- Results: UCH patient volumes have increased approximately 250% from
patible SPC training simulator received positive evaluations from urolo- year one to year four. Approximately 40% of patients treated at the UCH
gists and interventional radiologists as a useful model for teaching bedside did not reside in the Saskatoon area, consistent with our province–
ultrasound–guided SPC insertion. This model will be integrated into our wide coverage. Patient satisfaction with UCH services and UCH staff was
next annual urology boot camp curriculum, which will allow for further outstanding to good in all variables assessed. Patient wait times for consul-
evaluation. Additional research is required for construct validation. tations for erectile dysfunction and Peyronie’s disease (traditionally longest
Reference: wait time) decreased by 60% and the time from known elevated pros-
1. Wessells H, Angermeier KW, Elliott SP, et al. Male urethral stricture: tate–specific antigen (PSA) to prostate biopsy result decreased by 62%.
AUA guideline. Linthicum (MD): American Urological Association Although the overall ED visits for urological diagnoses did not decrease
Education and Research, Inc.; 2016 Apr. 34. with the UCH’s introduction, visits for postoperative complications/pain,
renal colic, urinary retention, and hematuria decreased, indicating some
MP–2.5 offloading of the ED.
What family doctors think of you: Use of an eConsult service Conclusions: Patient volumes and services have greatly expanded with
for physician–generated feedback to urologists the opening of the UCH. Patients report a high level of satisfaction with
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Luke Witherspoon , Justin Lee , John Mahoney 1 UCH services and staff with shorter wait times. The UCH is offloading
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1 Urology, University of Ottawa, Ottawa, ON, Canada ED volumes for certain urological conditions, which is likely a more
Introduction: Opportunities for physician feedback are limited, and efficient, cost–effective delivery of specialized patient care. The UCH
often focus on standardized performance reviews. These reviews have has developed into a highly functional microsystem within the larger
been shown to have little actual impact on a surgeons practice. There healthcare system .
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is currently no formalized system for physician–to–physician feedback
between primary care physicians (PCP) and urologists. We present a sys- MP–2.7
tem whereby PCPs are able to provide anonymized feedback to urologists Resident–run urology clinics: A potential tool for use in
in regard to the quality of their consults and medical advice. competency–based medical education for teaching and assessing
Methods: Urology physician feedback reports completed through the transition–to–practice skills
Champlain BASE service from March 2013 to November 2017 were Luke Witherspoon , Shreya Jalali , Matthew Roberts 1
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analyzed. The Champlain BASE service is a secure web–based system, 1 Urology, The Ottawa Hospital, Ottawa, ON, Canada; Medicine,
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where PCPs are able to send eConsults, instead of requesting a formal University of Ottawa, Ottawa, ON, Canada
in–office consultation for a patient. Each anonymized report allowed Introduction: In a competency–based approach to resident education,
PCPs to answer five questions regarding how the eConsult affected the a component of training should focus on skills needed for the transition
medical management of the patient, as well as the educational value of from residency to independent practice. The ability to run an outpatient
the interaction with the urologist. Feedback was given using either direct clinic represents one such skill. Resident–run clinics (RRCs) have been
response or ranking via a five–point Likert scale. implemented in family medicine programs to allow residents to practice
Results: A total of 411 feedback reports were analyzed. Of these reports, this skill, and have enhanced learning while providing excellent patient
89% ranked the urologists advice as 4/5 for usefulness to their patient, and satisfaction. 1–5 To date, there has been little experience with RRCs in surgi-
90% ranked the overall usefulness of the eConsult to the PCP as a 4/5. cal residency programs. We describe a uology RRC and report assessments
After October 2016, a question regarding educational value was added of both resident performance and patient satisfaction.
S74 CUAJ • June 2018 • Volume 12(6Suppl2)