| Association between implementation of a medical team training program and surgical morbidity. | |
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MedLine Citation:
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PMID: 22184295 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether there is an association between the Veterans Health Administration Medical Team Training (MTT) program and surgical morbidity. Design, Setting, and PARTICIPANTS: A retrospective health services study was conducted with a contemporaneous control group. Outcome data were obtained from the Veterans Health Administration Surgical Quality Improvement Program. The analysis included aggregated measures representing 119 383 sampled procedures from 74 Veterans Health Administration facilities that provide care to veterans. MAIN OUTCOME MEASURES: The primary outcome measure was the rate of change in annual surgical morbidity rate 1 year after facilities enrolled in the MTT program as compared with 1 year before and compared with the non-MTT program sites. RESULTS: Facilities in the MTT program (n = 42) had a significant decrease of 17% in observed annual surgical morbidity rate (rate ratio, 0.83; 95% CI, 0.79-0.88; P = .01). Facilities not trained (n = 32) had an insignificant decrease of 6% in observed morbidity (rate ratio, 0.94; 95% CI, 0.86-1.05; P = .11). After adjusting for surgical risk, we found a decrease of 15% in morbidity rate for facilities in the MTT program and a decrease of 10% for those not yet in the program. The risk-adjusted annual surgical morbidity rate declined in both groups, and the decline was 20% steeper in the MTT program group (P = .001) after propensity-score matching. The steeper decline in annual surgical morbidity rates was also observed in specific morbidity outcomes, such as surgical infection. CONCLUSION: The Veterans Health Administration MTT program is associated with decreased surgical morbidity. |
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Authors:
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Yinong Young-Xu; Julia Neily; Peter D Mills; Brian T Carney; Priscilla West; David H Berger; Lisa M Mazzia; Douglas E Paull; James P Bagian |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 146 ISSN: 1538-3644 ISO Abbreviation: Arch Surg Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1368-73 Citation Subset: AIM; IM |
Affiliation:
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National Center for Patient Safety, 215 N Main St, White River Junction, VT 05009. yinong.young-xu@va.gov. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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