Intervention Model: Clinical rotations
WEEK 1: PRE-OPERATIVE
Outpatient clinic and surgical cue triage
Assessment and plan of potential cases
WEEK 3 & 4:
Emergency neurosurgical procedures
Post-operative care & rehabilitation
Begin triage for next month's rotation
WEEK 2: OPERATIVE
Surgeries are supervised by a US faculty neurosurgeon
Cases are obtained from clinical assessments
Responsibilities of the visiting US team will include:
completion of the spectrum of inpatient and outpatient responsibilities inside and outside of the operating room required to successfully manage a neurosurgical service.
participation with on-site OR personnel to facilitate procurement of replacements for damaged or consumable instrumentation and material. The proposed intervention centers around a rotation at PIH HUM by senior level U.S. neurosurgical residents.
Protections: Promoting High-Quality Care
Multiple tiers of protection will be added to ensure that care is provided commensurate to that in US residency training programs.
Participating residents will be in the senior portion of their training.
For the duration of the rotation, a US-based attending will be present or available to assist in clinical plan formulation. All consultations will be discussed with the US- based neurosurgical attending.
For emergent scenarios, in the absence of a US neurosurgical attending, cases will be staffed by an attending HUM general surgeon. In all scenarios, management considerations will have been discussed with the attending on-call if that individual is not on-site.
Elective cases will be completed in the presence of the US-based attending that will be on-site for approximately one week per month.
Monthly service statistics and all episodes of morbidity and mortality will be discussed at the monthly quality assurance morbidity and mortality conference. M&M conference will take place at regardless of the program of origin of participating resident and attending.