ABSTRACT
Introduction: The delivery of optimal and safe medical care is critical in healthcare. The traditional practice of “See one, do one and teach one” residency training programme is no longer acceptable. Materials and Methods: In the past, there was no structured residency training programme in our hospital. There were several cases of organ injuries from surgeries performed by the residents. In 2005, we conducted a pilot study to organise a structured teaching, education, surgical accreditation and assessment (TESA) residency programme for 15 residents in the Division of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital. We performed a written questionnaire survey of the residents on the new programme and patients’ expectation (n = 2926) as subjective outcomes in the 1-year follow-up. We also studied the complication rates of all minor and major surgeries performed by the residents in 2004 and 2005 as an objective outcome. Results: All the residents (n = 15) surveyed supported the TESA programme. Patients’ expectation improved significantly from 71% in 2004 (n = 1559) to 83% in 2005 (n = 1367) (P = 0.03). There were 10,755 surgeries in 2004 and 10,558 surgeries in 2005 performed by our residents, with 6 cases (5.6%) of organ injuries in 2004 compared to 3 cases (2.8%) in 2005. This reduction was not statistically significant. Conclusion: The TESA residency programme in our hospital has an impact on the delivery of optimal and safe medical care while ensuring the training of residents to be competent specialists.
The delivery of good medical care and the safety of patients are of utmost importance in all healthcare systems. Indeed, healthcare providers need to rely on one anothers’skills to minimise risk and decrease the number of medical errors.1 This is of particular concern in the practice of obstetrics and gynaecology where medico-legal litigations are common. From 1975 to 2000, medical malpractice costs for obstetrician-gynaecologists have risen to nearly 4-fold, higher than other medical costs.2 In addition, it has been estimated that defensive medicine may cost society $80 billion per year.2 This risk and cost of adverse outcomes due to medical errors may be unnecessarily high.3 The liability insurance crisis has also contributed to increased efforts to improve the quality of healthcare for women.
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