PMID- 24440580 OWN - NLM STAT- MEDLINE DCOM- 20150413 LR - 20191210 IS - 1887-1364 (Electronic) IS - 1134-282X (Linking) VI - 29 IP - 1 DP - 2014 Jan-Feb TI - [Classification and monitoring of the appropriateness of emergency admissions in a tertiary hospital]. PG - 10-6 LID - S1134-282X(13)00067-5 [pii] LID - 10.1016/j.cali.2013.05.002 [doi] AB - OBJECTIVE: To measure the appropriateness of hospital admissions, to classify its Clinical Services (CS) according to the level of inappropriateness, and to determine the usefulness of applying rapid assessment techniques (lot quality assurance sampling) in these types of measurements. MATERIAL AND METHODS: A descriptive, retrospective study was conducted in a tertiary hospital to assess the clinical records of emergency admissions to the 12 CS with a higher volume of admissions, using the Appropriateness Evaluation Protocol (AEP). A four-level (<> to <>) increasingly inadequate admissions scale was constructed setting both standard and threshold values in every stratum. Every CS was classified in one of them using lot quality assurance sampling (LQAS). A total of 156 cases (13 cases from every CS) were assessed. The assessment effort (devoted time) was also estimated. RESULTS: There were 22.4+/-6.3% of inadequate admissions. In the CS classification, 9 (75%) got a good or acceptable appropriateness level, and only 1 (8%) got an inacceptable level. The time devoted was estimated at 17 hours. CONCLUSIONS: AEP is useful to assess the admission appropriateness and may be included in the <> process management, although its variability prevents the use for external comparisons. If both LQAS and the appropriateness classification level and the global estimation (by unifying lot samples) are combined, the monitoring is affordable without a great effort. To extend these tools to other quality indicators requiring direct observation or clinical records, manual assessment could improve the monitoring efficiency. CI - Copyright (c) 2013 SECA. Published by Elsevier Espana. All rights reserved. FAU - Lopez-Picazo Ferrer, J J AU - Lopez-Picazo Ferrer JJ AD - Unidad de Calidad Asistencial, Area I Murcia-Oeste, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Espana. Electronic address: julioj.lopez-picazo@carm.es. FAU - Tomas Garcia, N AU - Tomas Garcia N AD - Unidad de Calidad Asistencial, Area I Murcia-Oeste, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Espana. FAU - Cubillana Herrero, J D AU - Cubillana Herrero JD AD - Direccion medica, Area I Murcia-Oeste, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Espana. FAU - Gomez Company, J A AU - Gomez Company JA AD - Direccion medica, Area I Murcia-Oeste, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Espana. FAU - de Dios Canovas Garcia, J AU - de Dios Canovas Garcia J AD - Unidad de Calidad Asistencial, Area I Murcia-Oeste, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Espana. LA - spa PT - Journal Article TT - Estratificacion y monitorizacion de niveles de adecuacion de ingresos urgentes en un hospital de tercer nivel. DEP - 20140117 PL - Spain TA - Rev Calid Asist JT - Revista de calidad asistencial : organo de la Sociedad Espanola de Calidad Asistencial JID - 9601664 SB - IM MH - Adult MH - Diagnosis-Related Groups MH - Emergencies/*classification MH - Emergency Service, Hospital/*statistics & numerical data MH - Hospital Records MH - Hospitals, University/*statistics & numerical data MH - Humans MH - Medical Audit MH - Medical History Taking MH - Patient Admission/standards/*statistics & numerical data MH - *Process Assessment, Health Care/methods MH - Program Evaluation MH - Quality Assurance, Health Care/methods MH - Quality Indicators, Health Care MH - Retrospective Studies MH - Spain MH - Surgery Department, Hospital/statistics & numerical data MH - Tertiary Care Centers/*statistics & numerical data OTO - NOTNLM OT - Adecuacion ingreso OT - Appropriateness admissions OT - Lot quality acceptance sampling OT - Monitoring OT - Monitorizacion OT - Muestreo por aceptacion de lotes EDAT- 2014/01/21 06:00 MHDA- 2015/04/14 06:00 CRDT- 2014/01/21 06:00 PHST- 2013/03/06 00:00 [received] PHST- 2013/04/15 00:00 [revised] PHST- 2013/05/07 00:00 [accepted] PHST- 2014/01/21 06:00 [entrez] PHST- 2014/01/21 06:00 [pubmed] PHST- 2015/04/14 06:00 [medline] AID - S1134-282X(13)00067-5 [pii] AID - 10.1016/j.cali.2013.05.002 [doi] PST - ppublish SO - Rev Calid Asist. 2014 Jan-Feb;29(1):10-6. doi: 10.1016/j.cali.2013.05.002. Epub 2014 Jan 17.