Efficient evaluation of center-level emergency surgery performance using a high-yield procedure set: A step towards an EGS registry - 12/08/21
, Elinore J. Kaufman b , Phillip M. Dowzicky a , Dane R. Scantling b , Daniel N. Holena b Abstract |
Background |
Emergency general surgery (EGS) lacks mechanisms to compare performance between institutions. Focusing on higher-risk procedures may efficiently identify outliers.
Methods |
EGS patients were identified from the 2016 State Inpatient Databases of Florida, New York, and Kentucky. Risk-adjusted mortality was calculated as an O:E ratio, generating expected mortality from a model including demographic and procedural factors. Outliers were centers whose 90% confidence intervals excluded 1. This was repeated in several subsets, to determine if these yielded outliers similar to the overall dataset.
Results |
We identified 45,430 EGS patients. Overall, 3 high performing centers and 5 low performing centers were identified. Exclusion of appendectomies and cholecystectomies resulted in a remaining data set of 13,569 patients (29.9% of the overall data set), with 2 high performers and 5 low performers. One low performer in the limited data set was not identified in the overall set.
Conclusion |
Evaluation of 5 procedures, making up less than a third of EGS, identifies most outliers. A streamlined monitoring procedure may facilitate maintenance of an EGS registry.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Emergency General Surgery (EGS) lacks a system for accurate benchmarking. |
• | The majority of EGS consists of high-volume, low-risk operations. |
• | A limited subset of operations may be used to identify high and low performers. |
Keywords : Emergency general surgery, Outcomes, Benchmarking, Performance improvement
Plan
Vol 222 - N° 3
P. 625-630 - septembre 2021 Retour au numéro
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