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Healthcare Associated Infections II: Preventive Measures01:22

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Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
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Improving Statewide Post-Operative Sepsis Performance Measurement Using Hospital Risk Adjustment Within a Surgical

Jesse A Codner1, Eli Mlaver1, Gina Solomon2

  • 1Department of Surgery, Emory University, Atlanta, Georgia, USA.

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|December 29, 2023
PubMed
Summary
This summary is machine-generated.

Risk-adjusted rankings reveal true surgical sepsis performance among Georgia Quality Improvement Program hospitals. This comparison is crucial for identifying top performers and facilitating best practice sharing to improve patient outcomes.

Keywords:
post-operative sepsisrisk adjustmentsurgical collaborative

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Area of Science:

  • Surgical Quality Improvement
  • Healthcare Performance Measurement
  • Patient Safety

Background:

  • Georgia Quality Improvement Program (GQIP) hospitals underperform nationally in post-operative sepsis.
  • Accurate benchmarking is needed to identify performance variations within the GQIP surgical collaborative.

Purpose of the Study:

  • To compare crude versus risk-adjusted post-operative sepsis rankings for hospitals within the GQIP surgical collaborative.
  • To identify high and low performing hospitals based on adjusted sepsis rates.

Main Methods:

  • Utilized American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data from 2015-2020 for intra-abdominal general surgery patients.
  • Developed and validated a multivariable risk-adjustment model for post-operative sepsis using patient factors (age, ASA class, complexity, comorbidities, admission status, wound class).
  • Compared ordinal rankings and tertile changes between crude and risk-adjusted sepsis rates across 10 hospitals.

Main Results:

  • Included 20,314 patients with 595 post-operative sepsis cases; crude sepsis rates varied from 0.81% to 5.11%.
  • Risk adjustment significantly re-ranked nine out of 10 hospitals.
  • Four hospitals shifted performance tertiles after risk adjustment.

Conclusions:

  • Risk-adjusted post-operative sepsis rankings provide a more accurate assessment of hospital performance within the GQIP collaborative.
  • These adjusted metrics are essential for effective benchmarking and facilitating the exchange of best practices.
  • Improving sepsis outcomes requires understanding performance beyond crude rates.