Clinical Evidence
The Monitoring and Improvement of Surgical-Outcome Quality
Setting: 763-bed acute care teaching and research hospital
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.
References
Authors
William Woodall; Sandy Fogel; Stefan Steiner.
Source
Published in Journal of Quality Technology, Volume 47, Issue 4, p383-399.
Year
2015
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