对非计划重返手术室进行机构分析以确定质量改进领域。

An institutional analysis of unplanned return to the operating room to identify areas for quality improvement.

作者信息

Lin Yihan, Meguid Robert A, Hosokawa Patrick W, Henderson William G, Hammermeister Karl E, Schulick Richard D, Shelstad Ryan C, Wild Trevor T, McIntyre Robert C

机构信息

Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO, USA.

出版信息

Am J Surg. 2017 Jul;214(1):1-6. doi: 10.1016/j.amjsurg.2016.10.021. Epub 2016 Dec 13.

DOI:10.1016/j.amjsurg.2016.10.021

PMID:28057294

Abstract

BACKGROUND

Unplanned return to the operating room (uROR) has been suggested as a hospital quality indicator. The purpose of this study was to determine reasons for uROR to identify opportunities for patient care improvement.

METHODS

uROR reported by our institution's American College of Surgeons National Surgical Quality Improvement Program underwent secondary review.

RESULTS

The uROR rate reported by clinical reviewers was 4.3%. Secondary review re-categorized 64.7% as "true uROR" with the most common reasons for uROR being infection (30.9%) and bleeding (23.6%). Remaining cases were categorized as "false uROR" with the most common reasons being inadequate documentation (60.0%) and not directly related to index procedure (16.7%).

CONCLUSIONS

Strict adherence to NSQIP definitions results in misidentification of true uROR. This raises concerns for using NSQIP-identified uROR as a hospital quality metric. Improved processes of care to prevent infection and hemorrhage at our institution could reduce the rate of true uROR.

摘要