Dr. Greenberg’s research program is dedicated to improving the quality and safety of surgical care. She has two goals that guide her work: 1) to improve operative performance and patient safety; and 2) to decrease practice variation and engage patients and other stakeholders in promoting high quality surgical care for patients with cancer. Her diverse portfolio of projects is highly collaborative and crosses institutions and disciplines.
Operative Performance and Patient Safety
Dr. Greenberg’s research program aims to better understand and improve performance, including individual, team and system performance, in the operating room (OR). Prospectively recording operations allows a unique opportunity to study system, team and individual provider performance, which are interdependent and in aggregate determine the course of an operation and patient outcomes. Her team is developing a myriad of approaches to video capture in the OR to facilitate exploration of innovative approaches to improving quality, safety and effectiveness in surgical care, primarily through the development and implementation of evidence-based initiatives.
Her research team is pioneering a novel approach to surgical performance improvement — surgical coaching — which can target all areas of surgical performance, including technical skill, cognitive skill and interpersonal skill. Its major project is a statewide, video-based, peer coaching program, the Wisconsin Surgical Coaching Program, the first such program in existence. The program includes a structured approach to the recruitment and training of surgical coaches, as well as a longitudinal, interactive program for participating surgeons. In other work, Dr. Greenberg and her research team have a highly collaborative research program with the University of Michigan to employ the Wisconsin Surgical Coaching Program in a state-wide collaborative of bariatric surgeons, the Michigan Bariatric Surgery Collaborative. Their data infrastructure will allow Dr. Greenberg’s group to test the impact of surgical coaching on objective technical skill and perhaps most importantly patient outcomes.
In other work, Dr. Greenberg is partnering with colleagues in engineering on a project entitled “A Video Analytic Approach to Deconstructing Surgical Skill.” In this work, she and her research team are adapting a novel software for tracking hand motions from industrial engineering to study technical performance in the operating room. They have also partnered with collaborators from Anesthesia, Nursing and Human Factors Engineering to analyze data collected by AV recordings of complex operations and focus groups with front-line providers to explore team fluidity or the constant changing composition of teams in the OR in a project entitled “Human Factors Analysis of Team Fluidity in the Operating Room.”
Cancer Care Delivery and Patient Centered Outcomes Research
As a surgical oncologist, Dr. Greenberg has long been interested in addressing variations in surgical care for patients with cancer, particularly breast cancer. She serves as co-chair of the Cancer Care Delivery Research (CCDR) Committee of the American College of Surgeons Clinical Research Program in the Alliance for Clinical Trials in Oncology. This committee provides the majority of the infrastructure for her current research activities in cancer. She has successfully obtained three awards from the Patient Centered Outcomes Research Institute (PCORI) to support an investigation of post-treatment surveillance for breast, colon and lung cancers. She is the PI of the breast cancer project, which aims to develop a more patient-centered, risk-stratified, tailored approach to surveillance after breast cancer. The project creates several important new data sources that can be used for future cancer care delivery research projects. She is also involved in a multi-institutional collaborative which seeks to develop novel approaches to integrate multiple data sources and complex modeling to identify optimal treatment approaches for ductal carcinoma in situ (DCIS).
Wisconsin Surgical Outcomes Research Program (WiSOR)
Wisconsin Surgical Coaching Program
Wisconsin Vascular and Endovascular Research Network (WiVERN)