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Search results for "Surgical Complications"
- Agency for Healthcare Research and Quality (AHRQ)
- Surgical Complications
Journal Article > Review
Validity of the Agency for Healthcare Research and Quality Patient Safety Indicators and the Centers for Medicare and Medicaid Hospital-acquired Conditions: a systematic review and meta-analysis.
Winters BD, Bharmal A, Wilson RF, et al. Med Care. 2016;54:1105-1111.
The ability to use administrative data to measure patient safety is critical, because chart review is time-consuming and resource-intensive. The AHRQ Patient Safety Indicators (PSIs) and the CMS Hospital-acquired Conditions (HACs) aim to measure and track patient safety using administrative data. PSIs are often used for pay-for-performance, and CMS has a policy of nonpayment for hospitalizations associated with HACs. This systematic review found that PSIs and HACs have not been adequately validated compared to chart review and therefore may be subject to coding error. Establishing hospital quality or payment based on unvalidated metrics has consequences for patient safety efforts. These results suggest that unless further development and validation of administrative metrics occurs, widespread implementation of pay-for-performance efforts may not significantly improve patient safety.
Tools/Toolkit > Fact Sheet/FAQs
Rockville, MD: Agency for Healthcare Research and Quality; Revised December 2009. AHRQ Publication No. 10-M008.
This tip sheet provides 10 practical steps hospitals can undertake to improve patient safety, based on research funded by the Agency for Healthcare Research and Quality. The tips can be grouped into three areas: 1) reducing health care-acquired infections and retained surgical instruments through use of specific clinical practices; 2) improving drug safety by ensuring access to accurate drug information; and 3) improving the culture of safety through appropriate staffing and work hours for nurses and residents. These tips are based on high-quality research studies documenting the effectiveness of these interventions at reducing errors and improving safety for a broad range of patients.
Journal Article > Study
Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions.
Davenport DL, Henderson WG, Mosca CL, Khuri SF, Mentzer RM Jr. J Am Coll Surg. 2007;205:778-784.
Hospitals are urged to measure their safety culture through the use of one of several validated surveys that assess teamwork and organizational attitudes toward safety. Although several such surveys exist, evidence linking survey responses to improved patient outcomes is lacking. This AHRQ-funded study assessed the relationship between safety culture (as measured by the Safety Attitudes Questionnaire) and clinical outcomes in surgical patients, and found no clear relationship between perceived safety culture and risk-adjusted morbidity and mortality. However, reduced morbidity correlated with higher ratings of communication within surgical teams. This finding supports prior research that implicated communication failures as a cause of safety problems in surgery.
Journal Article > Study
Use of administrative data to find substandard care: validation of the complications screening program.
Weingart SN, Iezzoni LI, Davis RB, et al. Med Care. 2000;38:796-806.
This AHRQ-funded case-control study used physicians' clinical judgment about flagged complications to generate potential deficiencies in the quality of care. Compiling data for more than 1000 Medicare beneficiaries from acute-care hospitals, investigators captured cases with a documented surgical or medical complication along with matched controls without such complications. The authors report that potential quality problems were identified at much higher rates in the flagged cases, but the judgments made about quality were affected by many circumstances, such as the complexity of a given case. Therefore, while subjectivity in physician case review exists, this study offers a potential strategy for selecting cases that might increase the yield in such interpretations of quality.