Quality indicators in ambulatory surgery. A prospective study

Morales, Rafael; Esteve, N.; Carmona, A; García, Fernando L. de la Vega; Sánchez, Alejandro; Olesti, P

doi:10.1016/s0966-6532(00)00048-2

Cited by 8 publications

(4 citation statements)

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“…Some advocate that the substitution index and the unplanned admission index could be valid and easy indicators of the management and quality of care in ambulatory surgery units [19,20]. A difference could be made between early admissions (patients not discharged) and late admissions (patients readmitted), and both seem to be good indicators of stable quality care in outpatient surgery.…”

Section: Discussionmentioning

confidence: 99%

Outpatient thoracic surgical programme in 300 patients: clinical results and economic impact☆

Molins¹,

Fibla²,

Pérez³

et al. 2006

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Outpatient thoracic surgical programme in 300 patients: clinical results and economic impact☆

Molins¹,

Fibla²,

Pérez³

et al. 2006

European Journal of Cardio-Thoracic Surgery

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“…It is a broadly applicable outcome measure because unplanned reoperations are not specific, meaning they can occur after any surgical procedure [ 9 , 10 ]. Unplanned reoperations are also reliable because they are only performed when necessary and their incidence is easily tracked using administrative registries [ 11 , 12 ]. The incidence of unplanned reoperations in pediatric surgery varies from 0.8 to 7% in general pediatric surgery and up to 17% in pediatric neurosurgery [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The Incidence and Causes of Unplanned Reoperations as a Quality Indicator in Pediatric Surgery

2022

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Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of pediatric patients who underwent reoperation within the 30-day period after primary surgery, from 1 January 2018 to 31 December 2020 were retrospectively reviewed. The primary outcome of the study was the rate of uROR as a quality indicator in pediatric surgery. Secondary outcomes were indications for primary and secondary surgery, types and management of complications, factors that led to uROR, length of hospital stay, duration of surgery and anesthesia, and starting time of surgery. Results: A total of 3982 surgical procedures, under general anesthesia, were performed during the three-year study period (2018, n = 1432; 2019, n = 1435; 2020, n = 1115). Elective and emergency surgeries were performed in 3032 (76.1%) and 950 (23.9%) patients, respectively. During the study period 19 (0.5%) pediatric patients, with the median age of 11 years (IQR 3, 16), underwent uROR within the 30-day postoperative period. The uROR incidence was 6 (0.4%), 6 (0.4%), and 7 (0.6%) for years 2018, 2019, and 2020, respectively (p = 0.697). The incidence of uROR was significantly higher in males (n = 14; 73.7%) than in females (n = 5; 26.3%) (p = 0.002). The share of unplanned reoperations in studied period was 4.5 times higher in primarily emergency surgeries compared to primarily elective surgeries (p < 0.001). The difference in incidence was 0.9% (95% CI, 0.4–1.4). Out of children that underwent uROR within the 30-day period after elective procedures, 50% had American Society of Anesthesiologists (ASA) score three or higher (p = 0.016). The most common procedure which led to uROR was appendectomy (n = 5, 26.3%) while the errors in surgical technique were the most common cause for uROR (n = 11, 57.9%). Conclusion: Unplanned reoperations within the 30-day period after the initial surgical procedure can be a good quality indicator in pediatric surgery. Risk factors associated with uROR are emergency surgery, male gender, and ASA score ≥3 in elective pediatric surgery.

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“…Quality improvement efforts aimed at reducing the incidence of adverse events require systematic measurement and prospective recording. 4 Unfortunately, appropriate measures for monitoring the quality of care in general surgical practice are lacking. Mortality is rare for most procedures, and nonfatal complications often are too procedure-specific to be useful across the heterogeneous range of general surgical procedures.…”

mentioning

confidence: 99%

“…Occurrences are easily tracked using administrative complication registration data. 4 In some European countries (eg, Denmark, the Netherlands), tracking the rates of unplanned reoperation on surgical wards has recently been implemented as an indicator of the quality of care, and many governments are considering adding this to their health care quality and safety agendas. The aim of the present report is to evaluate whether the incidence of unplanned reoperation can be used as an indicator of the quality of patient care.…”

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confidence: 99%

Can the Incidence of Unplanned Reoperations Be Used as an Indicator of Quality of Care in Surgery?

2007

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The incidence of unplanned reoperations could potentially be used as an indicator of quality of care. This study provided insight into the incidence of unplanned reoperations in a surgical department and added to the discussion of the value of unplanned reoperations as an indicator of quality of care. Between January 1996 and December 2003, all unplanned reoperations were entered prospectively into a complication registration system. The number of unplanned reoperations was 447 (1.7%). Unplanned reoperations occurred frequently after vascular (6.5%) and colon surgery (5.7%) and were caused predominantly by errors in surgical technique (70%) and patients' comorbidities (21%). Mortality for patients requiring unplanned reoperations was significantly higher than for patients who did not require reoperations (10.3% versus 4.0%). Unplanned reoperation rates can be an indicator of quality of care. However, a prospective, well-defined registry is essential to ensure an accurate assessment of the quality of care provided.

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Quality indicators in ambulatory surgery. A prospective study

Cited by 8 publications

References 0 publications

Outpatient thoracic surgical programme in 300 patients: clinical results and economic impact☆

Outpatient thoracic surgical programme in 300 patients: clinical results and economic impact☆

The Incidence and Causes of Unplanned Reoperations as a Quality Indicator in Pediatric Surgery

Can the Incidence of Unplanned Reoperations Be Used as an Indicator of Quality of Care in Surgery?

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