This article in Health Leaders provides an important reminder about the need for performance improvement experts to understand our data in more detail. Many hospitals formally evaluate various surgical quality measures, including the Surgical Care Improvement Project (Core Measures), complications, infections, readmissions, mortality, returns to the OR, returns to the ICU. However, these hospitals may not be differentiating between Emergency Surgery vs. Elective Surgery, a variable that can change the likelihood of complications considerably.
This research being undertaken at Wake Forest University Medical Center underscores that unless we understand the variables behind the data that we are collecting, we will likely not understand how to truly improve outcomes.
Another danger in "aggregating data" - particularly in this day of mandated physician profiling, e.g., through the Ongoing Professional Practice Evaluation (OPPE) - is that we may project individual practitioners to have higher complication rates than their peers, when in reality they may have a selective patient population. For example, perhaps some practitioners take more emergency call than their peers, which would lead them to perform more emergent procedures.
Other variables, such as delay in performing surgery, quality of OR team, communication within the OR/ preoperative timeframe, may also play a role in the outcome of the procedure. However, unless we are attuned to these variables, capturing them, and studying them, we will not be serving the cause of improvement nor will we be able to effectively engage and help our physician colleagues as actively as we would like.
This research being undertaken at Wake Forest University Medical Center underscores that unless we understand the variables behind the data that we are collecting, we will likely not understand how to truly improve outcomes.
Another danger in "aggregating data" - particularly in this day of mandated physician profiling, e.g., through the Ongoing Professional Practice Evaluation (OPPE) - is that we may project individual practitioners to have higher complication rates than their peers, when in reality they may have a selective patient population. For example, perhaps some practitioners take more emergency call than their peers, which would lead them to perform more emergent procedures.
Other variables, such as delay in performing surgery, quality of OR team, communication within the OR/ preoperative timeframe, may also play a role in the outcome of the procedure. However, unless we are attuned to these variables, capturing them, and studying them, we will not be serving the cause of improvement nor will we be able to effectively engage and help our physician colleagues as actively as we would like.
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