Beyond requirements - Residency management through the Internet

Hypothesis: An Internet application could collect information to satisfy do cumentation required by the Residency Review Committee. Beyond replacing a difficult and inefficient paper system, it would collect, process, and dist ribute information to administration, faculty, and residents. Design: Descriptive study. Setting: An integrated residency of 18 services at a university teaching ho spital with 4 affiliated institutions. Participants: Residency administrators, faculty, and residents. Interventions: The application included a procedure recorder, resident eval uation of faculty and rotations, goals and objectives (stratified by servic e and resident level), and matching faculty evaluation of residents with th ese goals as competencies. Policies, schedules, research opportunities, cli nical site information, and curriculum support were created. Main Outcome Measures: Degree of compliance with Residency Review Committee standards, number of deficiencies corrected, and quantity and quality of i nformation available to administration, faculty, and residents. Results: The Internet system increased resident compliance for faculty and rotation evaluations from 20% and 34%, respectively, to 100%, which was mai ntained for 22 months. These evaluations can be displayed individually, in summary grids, and as postgraduate year-specific averages. Faculty evaluati ons of residents can be reviewed throughout the system. The defined categor y report for procedures, which had deficiencies in the preceding 6 years, h ad none for the last 2 years. The Internet application provides Accreditati on Council for Graduate Medical Education-validated operative logs to regul atory agencies. Conclusions; A Web-based system can satisfy requirements and provide proces sed data that are of better quality and more complete than our paper system . We are now able to use scarce time and personnel to nurture developing su rgical residents instead of shuffling paper.