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Research Development Program, 2001-2003

 

Philosophy

 

We believe that research should be:

 

Be continually done to improve quality of service, training, and governance of a department of surgery.

 

Be integrated into the day-to-day activities of a department of surgery and its staff, and not to be looked upon as something distinct and separate from service, training and governance and as an added burden for the staff.

 

Be mostly of the action research types so as to be relevant and useful in improving service, training, and governance.

 

Not be limited to clinical medicine but should include service, training, and governance.

 

Goal

 

To continually conduct research in order to improve the quality of service, training, and governance activities of the department of surgery.

 

Performance Objectives (Targets)

 

2001

2002

2003

At least 2 completed useful research papers per year

At least 4 completed useful research papers per year

At least 4 completed useful research papers per year

At least 2 papers presented in an external scientific forum

At least 2 papers presented in an external scientific forum

At least 2 papers presented in an external scientific forum

 

At least 2 papers for publication

At least 2 papers for publication

 

Annual research forum

Annual research forum

 

Active participation of consultants

Active participation of consultants

 

At least 6 clinical practice guidelines

At least 6 clinical practice guidelines

 

 

 

 

 

Strategies (general)

 

Effective leadership from chairperson down

            Effective in promoting achievement of performance objectives

            Effective in promoting achievement of the other strategies

           

            Leadership by training and coaching

Leadership by example

            Situational leadership – innovativeness and resourcefulness

 

Consultant-guided and assisted researches from chairperson down

 

Structured departmental research development program with clear philosophy, directions, and policies; realistic short- and long-term targets; doable strategies and research activities; regular bimonthly monitoring and updating; and continual quality improvement measures

 

Continuing education, training, and coaching of resident and consultant staff

 

Incentive- and motivation-provision for resident and consultant staff

 

Donor-enticement program 

 

Strategies (specific)

 

Attendance of residents and consultants in research training workshops within OMMC and outside (e.g. Philippine College of Surgeons) [2001-2003]

 

Study of “Instructions to Authors” of Philippine Journal of Surgical Specialties and Asian Surgical Association Journal with formulation of a checklist to be used to critique a written paper of a resident [2001]

 

Identification of research problems during regular departmental conferences – preop and postop conference, morbidity and mortality conferences, debates, case presentation and discussion, monthly performance reporting, administrative meetings, etc., resulting in action research topics on governance, service, and training [2002 – present]

 

Updating of research projects every 2 months [2002-present]

 

Holding of annual departmental research forum [August 2002, August 2003]

 

Use of consultants to serve as judges, critiquers, and feedbackers in the department’s annual research forum (2002 - present)

 

Participation in research contests inside (interdepartment) and outside OMMC (Philippine College of Surgeons and Philippine Society of General Surgeons) [2002 – present]

 

Participation in research fora outside OMMC (Philippine College of Surgeons’ Annual Convention Free Paper Presentation) [2002 – present]

 

Submission of completed research papers for publication in journals [2002 – present]

 

Dissemination of information derived from completed research projects to the public through print media (newspapers and health magazines) and emails [2002 – present]

 

Utilization of information derived from completed research projects within the department as new policies and practice guidelines [2002 – present]

 

Establishment and development of Multi-center Cooperative Collaborative Action Research Study among different surgeons and surgery departments throughout the country [2002 – present]

 

Use of consultants to assist residents in preparing for oral presentation in external fora and in preparing papers for publication [2002 – present]

 

Giving of incentive and motivation to the residents and consultants in the form of authorship, co-authorship, publication honor, and monetary awards.

 

 

Outcome

 

The 2001 performance objectives of at least 2 completed useful research papers per year and at least 2 papers presented in an external scientific forum were not achieved.

 

The 2002 performance objectives were achieved with:

 

-         9 finished papers, 3 case reports, 1 clinical practice guidelines, and 5 descriptive-analytical papers

-         all papers having been presented in various research forums, both internally in OMMC and externally in the Philippine Society of General Surgeons (PSGS) and Philippine College of Surgeons (PCS).  All the 5 descriptive-analytical papers were semi-finalists and finalists in research contests sponsored by PSGS and PCS with two 2 papers winning prizes.  One case report and one descriptive-analytic paper each won an award in the OMMC interdepartmental research contest in January, 2003.

-         A research forum held in August 13, 2002.

-         At least 5 consultants participating in the research activities of the department.

-         6 completed clinical practice guidelines.

-         Establishment of a Multi-center Cooperative Collaborative Action Research Study.

-         $1,000 research grant from North Texas Association of Philippine Physicians.

 

In 2003, at this writing, (June 30, 2003)

-         there are 16 ongoing papers.

-         the annual research forum will be in August, 2003

-         MCCCARS is still ongoing.

-         the research grant from NTAPP has been increased to $1,500.

-         MD Consult subscription and access to Internet through prepaid cards were started in March, 2003.

 

Future Plans:

            To sustain and institutionalize the research development program

To establish a core group of consultants to actively participate in the research program

 

 

2002

Outcome

2003

At least 4 completed useful research papers per year

9 papers

About 16 ongoing papers

At least 2 papers presented in an external scientific forum

9 papers

 

At least 2 papers for publication

1 case report already published (PJSS – Jan-Mar 2003)

5 other papers accepted for publication pending revisions

 

Annual research forum

August 13, 2003

August, 2003

Active participation of consultants

5 consultants

 

At least 6 clinical practice guidelines

6 practice guidelines

 

 

 

 

 

MCCCARS

MCCCARS

 

 

 

 

Research Grant of $1,000 from NTAPP

Research Grant of $1,500 from NTAPP

 

 

MD Consult subscription from a donor

 

 

Internet prepaid cards for all residents from a donor

 

 

2003 Ongoing Research Projects:

 

Prevention of surgical site infection in emergency colonic surgery with partial wound closure

 

Sudden cancellation of scheduled elective operations in a government tertiary hospital – a cause for concern and how to avoid

 

Reducing hypertension as a cause of sudden cancellation of elective operations in a government tertiary hospital

 

Tissue review in the prevention of unnecessary operations

 

Prevalence of fibrocystic changes in breast mass operations (MCCCARS)

 

Appendicitis

 

Validation of monitoring protocol for patients with possible acute appendicitis

 

Incidence of normal appendectomy rate and perforation rate

 

Variations in the diagnostic process of surgical staff in patients with acute non-traumatic right lower quadrant abdominal pain

 

Role of preoperative antibiotics and wound management in the prevention of surgical site infection in patients with acute appendicitis

 

Pain score and pain management in post-appendectomy patients

 

Incidence and avoidance of retained post-traumatic hemothorax

 

Incidence and reduction of mortality in major abdominal vascular injuries

 

Profile of soft tissue infection in OMMC

 

Reducing morbidity and mortality rates in OMMC Surgery

 

Reducing infection in hand injuries

 

Validation of a protocol in the selective use of mesh for inguinal herniorrhaphy

 

Pain Studies

 

Pain score and pain management in post-thyroidectomy patients

 

Pain score and pain management in post-modified radical mastectomy patients

 

Pain score and pain management in post-cholecystectomy patients

 

 

OMMC Surgery Cancer Pain Control Program

 

 

Case Reports

 

Fishbone ingestion causing surgical abdomen

 

Muriatic acid ingestion causing gastrointestinal tract necrosis and perforation