Resource use and postoperative outcome: basic elements in benchmarking

Niskanen, Minna

doi:10.1097/mcc.0b013e32832c95cb

Current Opinion in Critical Care

2009

DOI: 10.1097/mcc.0b013e32832c95cb

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Resource use and postoperative outcome: basic elements in benchmarking

Minna Niskanen

Abstract: There is a lot to do to achieve feasible quality indicators and methods for intrainstitutional and interinstitutional benchmarking. Using appropriate tools that are based on multicenter databases, resource use, outcome and effects of new treatment modalities could be more objectively estimated.

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Cited by 5 publications

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Outcomes of Laparoscopy Combined with Enhanced Recovery Pathway for Reversal of Hartmann’s Procedure

et al. 2015

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The objective of this study is to discuss the security and feasibility of the laparoscopic reversal of Hartmann's procedure (LRHP) on the concept of enhanced recovery after surgery (ERAS). The clinical data of 42 patients who underwent laparoscopic reversal of Hartmann's procedure was retrospectively analyzed, and the operative time, blood loss, intraoperative and postoperative complications, conversion to open surgery, postoperative hospital stay, and so on were observed. Twenty-nine patients (69.00 % of the study pool) received complete postoperative recovery courses as prescribed by enhanced recovery program (ERP). The postoperative length of stay (LOS) in the hospital was 5.6 (3-16 days). The overall and major (grades III to V) postoperative morbidities were 33.3 % ( = 14) and 4.8 % ( = 2), respectively. Our preliminary results showed that using the laparoscopic technology in reversal of Hartmann's colostomy on the concept of ERP is safe and feasible. Patients with intra- or postoperative complications were found to have statistically significant associations with greater risk of ERP failure.

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Outcomes of Laparoscopy Combined with Enhanced Recovery Pathway for Reversal of Hartmann’s Procedure

et al. 2015

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“Fast track surgery” in the north-west of Italy: influence on the orientation of surgical practice

et al. 2012

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Fast track surgery is a peri-operative management model, including different strategies to improve patients' convalescence, avoid metabolic alterations, reduce complications, and shorten hospital stay. Prerequisite is coordination between different practitioners (surgeon, anaesthetist, nurse, nutritionist, physiotherapist). The purpose of our investigation is to understand the level of fast track surgery application in Piedmont and to evidence analogies and differences among departments. We projected an investigation proposing, to every surgery department in Piedmont, a multiple-choice questionnaire evaluating the level of fast track surgery peri-operative interventions' application. Data analysis was conducted in two points of view: the transversal one with an overview of answer's percentages, the longitudinal one correlating data through Pearson's index (r). We collected answers by 78 % of balloted departments (38 on 49). Transversal analysis, including the evaluation of percentages of each question, shows that intra-operative period is the most influenced by fast track principles, and that only 12 departments of 38 apply complete protocols. Longitudinal analysis, estimating the whole of each department's answers, demonstrates the absence of statistical significance in the correlation between fast track surgery application and territorial (r = 0.18), economic (r = 0.31), or age (r = 0.06) variables. Influence of fast track surgery is significantly present in our territory, even though it is not fully concretized in protocols. The choice of fast track depends on the instruction, the environment and the sensibility of each surgeon. Knowledge of geographic distribution of departments applying this model can be useful to organize common protocols, starting from more experienced hospitals.

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Multimodal Rehabilitation Programme in Elective Colorectal Surgery: Impact on Hospital Costs

Salvans¹,

Gil-Egea²,

Pera³

et al. 2013

Cirugía Española (English Edition)

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Resource use and postoperative outcome: basic elements in benchmarking

Cited by 5 publications

References 34 publications

Outcomes of Laparoscopy Combined with Enhanced Recovery Pathway for Reversal of Hartmann’s Procedure

Outcomes of Laparoscopy Combined with Enhanced Recovery Pathway for Reversal of Hartmann’s Procedure

“Fast track surgery” in the north-west of Italy: influence on the orientation of surgical practice

Multimodal Rehabilitation Programme in Elective Colorectal Surgery: Impact on Hospital Costs

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