MP02-17 THE JULY EFFECT IN UROLOGIC SURGERY: MYTH OR REALITY? Article Swipe

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety I1 Apr 2018MP02-17 THE JULY EFFECT IN UROLOGIC SURGERY: MYTH OR REALITY? Eric Kirshenbaum, Robert Blackwell, Belinda Li, Emmanuel Eguia, Gopal Gupta, Kristin Baldea, Robert Flanigan, Paul Kuo, and Alex Gorbonos Eric KirshenbaumEric Kirshenbaum More articles by this author , Robert BlackwellRobert Blackwell More articles by this author , Belinda LiBelinda Li More articles by this author , Emmanuel EguiaEmmanuel Eguia More articles by this author , Gopal GuptaGopal Gupta More articles by this author , Kristin BaldeaKristin Baldea More articles by this author , Robert FlaniganRobert Flanigan More articles by this author , Paul KuoPaul Kuo More articles by this author , and Alex GorbonosAlex Gorbonos More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.143AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The July Effect is the commonly held belief that patient related outcomes are compromised at the beginning of the academic year due to the transition of medical trainees. There is a paucity of literature regarding whether the July effect exists in urology patients. We sought to determine if the July effect had an impact on surgical outcomes. METHODS The Healthcare Cost and Utilization Project State Inpatient Database, State Ambulatory Surgery and Services Database and State Emergency Department Database for the state of California were utilized for years 2007-2011. ICD-9 and CPT codes were utilized to identify patients who underwent both major and minor urologic surgery. We identified patients who underwent surgery in July, August, April and May and separated patients into early (July and August) and late (April and May) cohorts. Surgical outcomes for early vs. late surgery were compared for academic centers. RESULTS Between 2007 and 2011, 45,155 patients underwent urologic surgery in July/August vs 43,479 who underwent surgery in April/May in the academic setting. For major urologic surgery(cystectomy, prostatectomy, nephrectomy, partial nephrectomy) July/August surgery had no impact on length of stay, 30 day readmissions, 30 day emergency room visits, never events, perioperative complications or mortality rates (all p-values >0.05). Similarly, for stone surgery, groin procedures, bladder outlet procedures and cystoscopic bladder procedures July/August surgery had no impact on rates of urinary retention, ER visits within 30 days, clot evacuations within 30 days, perioperative complications or 30 day readmissions (all p-values >0.05). Cystectomies had higher rates of intraoperative complications (OR 0.63(CI 0.4-0.97) and accidental punctures(OR 0.48(CI 0.25-0.89) at the end of the academic year representing a reverse July effect. CONCLUSIONS Our study demonstrated that surgical outcomes are not compromised by having surgery at the beginning of the academic year despite resident turnover. The study suggests, that in the current state of urology education, academic institutions are providing appropriate oversight during this vulnerable time. Conversely, care must be focused on preventing complications associated with resident autonomy at the end of the academic cycle. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e18-e19 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Eric Kirshenbaum More articles by this author Robert Blackwell More articles by this author Belinda Li More articles by this author Emmanuel Eguia More articles by this author Gopal Gupta More articles by this author Kristin Baldea More articles by this author Robert Flanigan More articles by this author Paul Kuo More articles by this author Alex Gorbonos More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...