The Search for an Outcome Variable That Measures Both Quality and Processes in Cardiac Surgery: Comparing the Quality
Paulien C Hoefsmit1, Evert K Jansen1, Ronald J M M Does2
1Department of Cardiothoracic Surgery, Amsterdam University Medical Centre, 1081HV Amsterdam, The Netherlands.
Healthcare (Basel, Switzerland)
|May 27, 2023
Summary
A new Quality Process Index (QPI) offers a stable measure for healthcare quality and process improvement. It provides a more comprehensive view than fluctuating mortality rates, aiding clinical practice insights.
Area of Science:
- Healthcare Quality Improvement
- Clinical Data Analysis
- Surgical Process Monitoring
Background:
- Translating vast clinical data into actionable insights for daily practice remains a challenge.
- Hospital-level quality and process assessment is often overwhelming due to data volume.
- A novel Quality Process Index (QPI) was developed to summarize clinical data for quality measurement.
Purpose of the Study:
- To develop and validate a Quality Process Index (QPI) for measuring healthcare quality and processes.
- To compare the QPI with traditional mortality rates as quality indicators.
- To analyze the evolution of quality and processes in cardiac surgery over a decade.
Main Methods:
- The Quality Process Index (QPI) was constructed using data from the Amsterdam Cardiosurgical Database (2011-2021, n=5497).
- Retrospective analysis of QPI and mortality rates (30-day and 120-day) for various surgery types.
- Statistical comparison of QPI stability versus mortality rate fluctuations.
Main Results:
- The mean Quality Process Index (QPI) remained relatively stable, despite statistically significant year-to-year differences (p < 0.001).
- Mortality rates showed more fluctuation, with no significant difference in means for 30-day or 120-day outcomes.
- A statistically significant negative correlation was found between QPI and mortality rates (r=-0.07 for 30-day, r=-0.12 for 120-day).
Conclusions:
- The Quality Process Index (QPI) effectively translates complex clinical data into a quantifiable measure for quality and process improvement.
- While mortality is crucial, the QPI offers a more stable and comprehensive metric for assessing healthcare quality trends.
- The QPI enhances the understanding and quantification of quality and process improvement in healthcare settings.
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