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The Monitoring and Improvement of Surgical-Outcome Quality
Objective
This expository study features a NSQIP surgical quality improvement project involving the implementation of multiple best practices over a five-year period, including computerized decision support (EndoTool) for post-operative blood glucose management.
Setting
763-bed acute care teaching and research hospital.
Results
- Surgical site infections decreased 42.5% over a five-year period, from an O/E ratio of 1.6 to 0.92.
- 30-day mortality decreased 51.4% over a five-year period, from an O/E ratio of 1.7 to .83, and from 3.7% to 1.8% of surgeries.
- Incidence of hyperglycemia >150 mg/dL decreased 48.4% with EndoTool, from 31% to 16% of patients.
Conclusions
Participation in NSQIP or some other collaborative network of hospitals is strongly encouraged, as the business case for adoption of surgical process improvements is supported by lower incidence of surgical site infections, 30-day mortality and hyperglycemia.
Authors
William Woodall; Sandy Fogel; Stefan Steiner.
Source
Published in Journal of Quality Technology, Volume 47, Issue 4, p383-399.
Year
2015
Tags
- Hypoglycemia Reduction
- Hyperglycemia Reduction
- Length of Stay
- Hospital-Acquired Conditions
- Healthcare-Associated Infections
- Surgical Site Infections
- Cost Savings
- Cost Savings|Hyperglycemia Reduction|Hypoglycemia Reduction|Length of Stay
- Time to Target
- Time in Range
- Time on IV Insulin
- Target Goal Attainment
- Mean Glucose Improvement
- Glucose Variability
- Burn Injury
- Cardiac Surgery
- DKA/HHS Management
- Emergency Department
- Induced Hypothermia
- Intra-op Glucose Management
- Obstetrics/Labor & Delivery
- Pediatrics
- Residual Insulin Adjustment
- BG Check Compliance
- BG Test Reduction
- Nursing Satisfaction
- Protocol Adherence
- Provider Satisfaction
- Workflow Improvements
- Nursing Satisfaction|Workflow Improvements