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Search results for "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.
Rockville, MD: Agency for Healthcare Research and Quality.
In this annual publication, AHRQ reviews the results of the National Healthcare Quality Report and National Healthcare Disparities Report. Providing a 5-year update on the National Quality Strategy, this report highlights that a wide range of quality measures have shown improvement in quality, access, and cost.
Journal Article > Study
Agency for Healthcare Research and Quality pediatric indicators as a quality metric for surgery in children: do they predict adverse outcomes?
Rhee D, Zhang Y, Papandria D, Ortega G, Abdullah F. J Pediatr Surg. 2012;47:107-111.
The Agency for Healthcare Research and Quality's Patient Safety Indicators (PSIs) are widely used to screen administrative data for evidence of adverse events in adult inpatients. The Pediatric Quality Indicators (PDIs) aim to fill the same role for pediatric hospitals, and this study provides strong evidence that they can identify patients who experience preventable harm. Evaluation of nearly 2 million pediatric discharges over a 20-year period found that patients who experienced one PDI had a 20% increased risk of mortality. The PDIs include postoperative complications such as respiratory failure, a case of which is discussed vividly in this AHRQ WebM&M commentary.
Journal Article > Study
Friedman B, Encinosa W, Jiang HJ, Mutter R. Med Care. 2009;47:583-590.
Preventable medical errors have been linked to longer hospitalizations, excess costs, and increased mortality. This study explored the longer term effects of patient safety incidents by exploring whether adverse events, as measured by AHRQ's Patient Safety Indicators, were linked to an increased risk of hospital readmission. Patients who suffered a pulmonary embolism or an accidental puncture or laceration during hospitalization were significantly more likely to be readmitted within 1 month, and a broad array of adverse events were linked to a 3-month increased readmission risk. Two cases of preventable readmissions are discussed in this AHRQ WebM&M commentary.