• Suliat M Nurudeen, Gifty Kwakye, William R Berry, Elliot L Chaikof, Keith D Lillemoe, Frederick Millham, Marc Rubin, Steven Schwaitzberg, Robert C Shamberger, Michael J Zinner, Luke Sato, Stuart Lipsitz, Atul A Gawande, and Alex B Haynes.
• Ariadne Labs, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard School of Public Health, Boston, MA.
• J. Am. Coll. Surg. 2015 Oct 1;221(4):837-44.

BackgroundMedical organizations have increased interest in identifying and improving behaviors that threaten team performance and patient safety. Three hundred and sixty degree evaluations of surgeons were performed at 8 academically affiliated hospitals with a common Code of Excellence. We evaluate participant perceptions and make recommendations for future use.Study DesignThree hundred and eighty-five surgeons in a variety of specialties underwent 360-degree evaluations, with a median of 29 reviewers each (interquartile range 23 to 36). Beginning 6 months after evaluation, surgeons, department heads, and reviewers completed follow-up surveys evaluating accuracy of feedback, willingness to participate in repeat evaluations, and behavior change.ResultsSurvey response rate was 31% for surgeons (118 of 385), 59% for department heads (10 of 17), and 36% for reviewers (1,042 of 2,928). Eighty-seven percent of surgeons (95% CI, 75%-94%) agreed that reviewers provided accurate feedback. Similarly, 80% of department heads believed the feedback accurately reflected performance of surgeons within their department. Sixty percent of surgeon respondents (95% CI, 49%-75%) reported making changes to their practice based on feedback received. Seventy percent of reviewers (95% CI, 69%-74%) believed the evaluation process was valuable, with 82% (95% CI, 79%-84%) willing to participate in future 360-degree reviews. Thirty-two percent of reviewers (95% CI, 29%-35%) reported perceiving behavior change in surgeons.ConclusionsThree hundred and sixty degree evaluations can provide a practical, systematic, and subjectively accurate assessment of surgeon performance without undue reviewer burden. The process was found to result in beneficial behavior change, according to surgeons and their coworkers.Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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