| Surgical adverse outcome reporting as part of routine clinical care. | |
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MedLine Citation:
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PMID: 20430928 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: In The Netherlands, health professionals have created a doctor-driven standardised system to report and analyse adverse outcomes (AO). The aim is to improve healthcare by learning from past experiences. The key elements of this system are (1) an unequivocal definition of an adverse outcome, (2) appropriate contextual information and (3) a three-dimensional hierarchical classification system. OBJECTIVES: First, to assess whether routine doctor-driven AO reporting is feasible. Second, to investigate how doctors can learn from AO reporting and analysis to improve the quality of care. METHODS: Feasibility was assessed by how well doctors reported AO in the surgical department of a Dutch university hospital over a period of 9 years. AO incidence was analysed per patient subgroup and over time, in a time-trend analysis of three equal 3-year periods. AO were analysed case by case and statistically, to learn lessons from past events. RESULTS: In 19,907 surgical admissions, 9189 AOs were reported: one or more AO in 18.2% of admissions. On average, 55 lessons were learnt each year (in 4.3% of AO). More AO were reported in P3 than P1 (OR 1.39 (1.23-1.57)). Although minor AO increased, fatal AO decreased over time (OR 0.59 (0.45-0.77)). CONCLUSIONS: Doctor-driven AO reporting is shown to be feasible. Lessons can be learnt from case-by-case analyses of individual AO, as well as by statistical analysis of AO groups and subgroups (illustrated by time-trend analysis), thus contributing to the improvement of the quality of care. Moreover, by standardising AO reporting, data can be compared across departments or hospitals, to generate (confidential) mirror information for professionals cooperating in a peer-review setting. |
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Authors:
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J Kievit; M Krukerink; P J Marang-van de Mheen |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-04-29 |
Journal Detail:
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Title: Quality & safety in health care Volume: 19 ISSN: 1475-3901 ISO Abbreviation: Qual Saf Health Care Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-03 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101136980 Medline TA: Qual Saf Health Care Country: England |
Other Details:
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Languages: eng Pagination: e20 Citation Subset: H |
Affiliation:
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Department of Medical Decision Making, Leiden University Medical Centre, The Netherlands. j.kievit@lumc.nl |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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