PMID- 31560298
OWN - NLM
STAT- MEDLINE
DCOM- 20191004
LR  - 20191007
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 85
IP  - 8
DP  - 2019 Aug 1
TI  - Clavien-Dindo Analysis of NSQIP Data Objectively Measures Patient-Focused 
      Quality.
PG  - 789-793
AB  - Current quality measures intended to drive improved clinical performance are 
      perceived as an inappropriate administrative burden. Surgeon-constructed quality 
      measures, including the NSQIP, are more closely aligned with provider performance 
      and relevant outcome. We hypothesized that NSQIP participation would be 
      associated with measurable improvement in surgical outcomes. Elective general 
      surgical cases were compared by case volume and incidence of postoperative 
      adverse events (AEs) from 2014 to 2017. Using the Clavien-Dindo severity scaling 
      system, we summed the grades for each AE and defined the patient population 
      burden of these AEs as this sum divided by case volume. Case volume samples 
      increased 67 per cent from 2014 (n = 526, 30 day complete) to 2017 (n = 878). 
      Ratio of patient burden to case volume improved from 0.92 (2014) to 0.73 (2017). 
      Comparison of AE incidence was not significantly different; however, the majority 
      decreased over time. Analysis of individual AE interval change identified 
      sepsis-related respiratory care as the top priority performance improvement 
      target. These data reflect improved performance for a growing volume of surgical 
      procedures. The impact of perioperative morbidity and their associated burden on 
      affected patients has decreased, demonstrating the value of combining NSQIP with 
      Clavien-Dindo to measure the quality of surgical care in objective and 
      patient-specific terms.
FAU - Gurien, Lori A
AU  - Gurien LA
FAU - Ra, Jin H
AU  - Ra JH
FAU - Crandall, Marie
AU  - Crandall M
FAU - Kerwin, Andrew J
AU  - Kerwin AJ
FAU - Tepas, Joseph J 3rd
AU  - Tepas JJ 3rd
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - Databases, Factual
MH  - Elective Surgical Procedures/adverse effects/*standards
MH  - Humans
MH  - Postoperative Complications/*epidemiology
MH  - *Quality of Health Care
MH  - Risk Assessment
MH  - United States/epidemiology
EDAT- 2019/09/29 06:00
MHDA- 2019/10/08 06:00
CRDT- 2019/09/28 06:00
PHST- 2019/09/28 06:00 [entrez]
PHST- 2019/09/29 06:00 [pubmed]
PHST- 2019/10/08 06:00 [medline]
PST - ppublish
SO  - Am Surg. 2019 Aug 1;85(8):789-793.