Thomas Robinson, MD, professor of GI, trauma, and endocrine surgery, has taken over the role of vice chair of quality and safety in the University of Colorado Department of Surgery.
In his new role, Robinson will oversee four large-scale quality projects over the next year, including a protocol to optimize patients pre-surgery to give them the best possible post-operative surgical outcomes.
“Before surgery, we plan to partner with patients to improve their nutrition and promote physical activity with the goal of improving their postoperative outcomes,” says Robinson, former chief of surgery at the Rocky Mountain Regional VA Medical Center. “The most unique aspect of surgery patients, when it comes to complications and safety events, is that surgeons schedule elective operations. Because surgeons schedule an operation, they have the opportunity to optimize the patient’s health prior to the operation.”
Prevention and support
Other quality and safety initiatives in the works at the CU Department of Surgery are an infection prevention program, a project to prevent post-operative delirium, and a system to provide surgical providers with emotional support after a major clinical adverse event such as a patient death.
“We want to have a mechanism to provide support if surgical team members are negatively impacted after a major clinical adverse event,” Robinson says. “The goal is to preserve our providers’ well-being. When a major adverse event happens to a surgery patient, it can be a negative psychological experience for the clinical teams involved. Developing a process to support surgeon providers after adverse clinical events represents an important opportunity that is currently not addressed.”
Fewer bed days
Additional priorities for Robinson in his new role include a continued focus on preventing blood clots after surgery and an effort to reduce hospital bed days — primarily by working to prevent readmissions and post-operative emergency room visits.
“Our plan is to develop consistent processes to avoid excessive length of stay and unexpected touches to the health care system,” he says. “From a hospital perspective, reducing bed days reduces cost. From a patient perspective, there’s the distress patients and their caregivers experience when a patient becomes ill enough to require an unexpected visit or admission to the hospital.”
Focus on older patients
Robinson’s quality and safety role goes hand in hand with his other new title in the CU Department of Surgery: head of the new Aging Surgical Wellness quality program.
“We plan to the improve the care of geriatric patients around major operations,” he says. “Geriatric patients are unique, physiologically and socially, and pre-operative care processes need to address the clinical characteristics unique to the older adult. Our program will be dedicated to preserving the mental and physical function of older adults undergoing major operations.
Continuing a legacy
The role of vice chair of quality and safety was previously held by Ethan Cumbler, MD, founding member of the Institute of Health Care Quality, Safety and Efficiency at the University of Colorado School of Medicine. Cumbler led efforts in the Department of Surgery to give patients rapid, uncomplicated recoveries after their operations. Robinson says he will continue the work that Cumbler started.
“We are going to build on the successful quality initiatives Dr. Cumbler has worked on in the past as we move forward with our surgical team’s quality and safety efforts,” Robinson says.
