改善全州的术后败血症绩效测量使用医院风险调整在一个外科合作的医院风险调整
Jesse A Codner1, Eli Mlaver1, Gina Solomon2
1Department of Surgery, Emory University, Atlanta, Georgia, USA.
Surgical infections
|December 29, 2023
概括
经风险调整的排名揭示了乔治亚州质量改善计划医院中真正的手术性败血症表现. 这种比较对于识别表现最佳者和促进最佳实践共享以改善患者结果至关重要.
科学领域:
- 改善外科手术的质量
- 医疗保健绩效测量方法 医疗保健绩效测量方法
- 患者安全 患者安全
背景情况:
- 乔治亚州质量改善计划 (GQIP) 医院在手术后败血症方面表现不佳.
- 需要准确的基准测试来识别GQIP手术协作中的性能变化.
研究的目的:
- 为了比较GQIP手术协作中的医院的原始与风险调整后败血症排名.
- 根据调整的败血症率来确定高和低表现的医院.
主要方法:
- 利用美国外科医生学院国家外科质量改进计划 (ACS-NSQIP) 的2015-2020年数据,用于腹部内外科全科医生患者.
- 开发并验证了使用患者因素 (年龄,ASA类,复杂性,并发症,入院状态,伤口类) 的术后败血症多变量风险调整模型.
- 在10家医院中,比较了原始和风险调整的败血症率之间的顺序排名和三级变化.
主要成果:
- 包括20314名患者,595例术后败血症病例;原始败血症率从0.81%到5.11%不等.
- 风险调整显著地重新排名了10家医院中的9家.
- 在风险调整后,四家医院转移了绩效三位数.
结论:
- 经风险调整的手术后败血症排名为GQIP协作中医院绩效提供了更准确的评估.
- 这些调整后的指标对于有效的基准测试和促进最佳实践交流至关重要.
- 改善败血症的结果需要了解超越原油价格的表现.
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