PMID- 24108144
OWN - NLM
STAT- MEDLINE
DCOM- 20160104
LR  - 20221207
IS  - 1536-3708 (Electronic)
IS  - 0148-7043 (Print)
IS  - 0148-7043 (Linking)
VI  - 74
IP  - 5
DP  - 2015 May
TI  - Patient safety in plastic surgery: identifying areas for quality improvement 
      efforts.
PG  - 597-602
LID - 10.1097/SAP.0b013e318297791e [doi]
AB  - Improving quality of health care is a global priority. Before quality benchmarks 
      are established, we first must understand rates of adverse events (AEs). This 
      project assessed risk-adjusted rates of inpatient AEs for soft tissue 
      reconstructive procedures.Patients receiving soft tissue reconstructive 
      procedures from 2005 to 2010 were extracted from the Nationwide Inpatient Sample. 
      Inpatient AEs were identified using patient safety indicators (PSIs), established 
      measures developed by Agency for Healthcare Research and Quality.We identified 
      409,991 patients with soft tissue reconstruction and 16,635 (4.06%) had a PSI 
      during their hospital stay. Patient safety indicators were associated with 
      increased risk-adjusted mortality, longer length of stay, and decreased routine 
      disposition (P < 0.01). Patient characteristics associated with a higher 
      risk-adjusted rate per 1000 patients at risk included older age, men, nonwhite, 
      and public payer (P < 0.05). Overall, plastic surgery patients had significantly 
      lower risk-adjusted rate compared to other surgical inpatients for all events 
      evaluated except for failure to rescue and postoperative hemorrhage or hematoma, 
      which were not statistically different. Risk-adjusted rates of hematoma 
      hemorrhage were significantly higher in patients receiving size-reduction 
      surgery, and these rates were further accentuated when broken down by sex and 
      payer. In general, plastic surgery patients had lower rates of in-hospital AEs 
      than other surgical disciplines, but PSIs were not uncommon. With the 
      establishment of national basal PSI rates in plastic surgery patients, benchmarks 
      can be devised and target areas for quality improvement efforts identified. 
      Further prospective studies should be designed to elucidate the drivers of AEs 
      identified in this population.
FAU - Hernandez-Boussard, Tina
AU  - Hernandez-Boussard T
AD  - From the *Department of Surgery, Stanford University School of Medicine; daggerCenter 
      for Health Policy, Stanford University, Stanford; double daggerRehabilitation Research and 
      Development, Department of Veterans Affairs (VA) Palo Alto Health Care System, 
      Palo Alto; and  section signDivision of Plastic Surgery, Stanford University, Stanford, CA.
FAU - McDonald, Kathryn M
AU  - McDonald KM
FAU - Rhoads, Kim F
AU  - Rhoads KF
FAU - Curtin, Catherine M
AU  - Curtin CM
LA  - eng
GR  - K01 HS018558/HS/AHRQ HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Ann Plast Surg
JT  - Annals of plastic surgery
JID - 7805336
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Lipectomy/standards
MH  - Male
MH  - Middle Aged
MH  - Models, Statistical
MH  - Patient Safety/*statistics & numerical data
MH  - Postoperative Complications/epidemiology/etiology
MH  - *Quality Improvement
MH  - Quality Indicators, Health Care/*statistics & numerical data
MH  - Plastic Surgery Procedures/*standards/statistics & numerical data
MH  - Risk Adjustment
MH  - Risk Factors
MH  - Surgery, Plastic/*standards/statistics & numerical data
MH  - United States
MH  - Young Adult
PMC - PMC4886543
MID - NIHMS701757
OID - NLM: HHSPA701757
COIS- Conflict of Interest. None.
EDAT- 2013/10/11 06:00
MHDA- 2016/01/05 06:00
PMCR- 2016/05/31
CRDT- 2013/10/11 06:00
PHST- 2013/10/11 06:00 [entrez]
PHST- 2013/10/11 06:00 [pubmed]
PHST- 2016/01/05 06:00 [medline]
PHST- 2016/05/31 00:00 [pmc-release]
AID - 10.1097/SAP.0b013e318297791e [doi]
PST - ppublish
SO  - Ann Plast Surg. 2015 May;74(5):597-602. doi: 10.1097/SAP.0b013e318297791e.