Literature DB >> 17544074

Relationship of processes and structures of care in general surgery to postoperative outcomes: a descriptive analysis.

Deborah S Main1, William G Henderson, Katherine Pratte, Tia A Cavender, Tracy L Schifftner, Anne Kinney, Tamara Stoner, John F Steiner, Aaron S Fink, Shukri F Khuri.   

Abstract

BACKGROUND: The systematic collection of quantitative data on structures and processes from surgical services participating in the National Surgical Quality Improvement Program (NSQIP) has not been a focus to date. Efficient collection of useful measures of structures and processes may improve understanding of surgical outcomes and strategies for improving the quality of surgical care, as NSQIP continues to expand. The purpose of this article was to describe results of a quantitative survey designed to measure surgical care structures and processes within NSQIP sites. STUDY
DESIGN: A cross-sectional survey was mailed to 123 Department of Veteran Affairs (VA) and 14 private sector sites participating in the Agency for Healthcare Research and Quality (AHRQ)-funded Patient Safety in Surgery (PSS) Study. The survey included questions about organizational structures and processes of preoperative, intraoperative, and postoperative general surgical care services. For this study, we included only data from 90 VA sites that returned a survey (73% response rate). We used descriptive statistics and examined the bivariate association of structures and processes items or scales with risk-adjusted observed-to-expected (O/E) ratios of surgical morbidity and mortality.
RESULTS: Examination of frequency or means and standard deviations of items and scales revealed substantial variation in the structures and processes of surgical care services in participating VA sites, with correlation analyses demonstrating that, of 35 process and structure variables, there was a statistically significant relationship with the hospital's observed-to-expected ratio for 14 variables for morbidity, but only 4 variables for mortality.
CONCLUSIONS: This descriptive analysis provides support for the potential importance of measuring organizational structures and processes of care in addition to risk-adjusted morbidity and mortality.

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Year:  2007        PMID: 17544074     DOI: 10.1016/j.jamcollsurg.2007.03.019

Source DB:  PubMed          Journal:  J Am Coll Surg        ISSN: 1072-7515            Impact factor:   6.113


  10 in total

1.  First Successful Large-Scale Introduction of an Enhanced Recovery after Bariatric Surgery (ERABS) Program in the Middle East: The Results and Lessons Learned of Tawam Hospital/Johns Hopkins, a Tertiary Governmental Center in the UAE.

Authors:  Guido H H Mannaerts; Rowaa E A Allatif; Fatima Y Al Hashmi; Arati Bhosale; Ahmad N Hammo; Sujoud H Isied; Warda A Qureshi; Omar S Al Hamad; Yasser Kayyal; Hmouda S T Al Afari
Journal:  Obes Surg       Date:  2019-07       Impact factor: 4.129

2.  Results of Implementing an Enhanced Recovery After Bariatric Surgery (ERABS) Protocol.

Authors:  Guido H H Mannaerts; Stefanie R van Mil; Pieter S Stepaniak; Martin Dunkelgrün; Marcel de Quelerij; Serge J Verbrugge; Hans F Zengerink; L Ulas Biter
Journal:  Obes Surg       Date:  2016-02       Impact factor: 4.129

3.  Where the Other Half Dies: Analysis of Mortalities Occurring More Than 30 Days After Complex Cancer Surgery.

Authors:  Benjamin J Resio; Lou Gonsalves; Maureen Canavan; Lloyd Mueller; Cathryn Phillips; Tejas Sathe; Katrina Swett; Daniel J Boffa
Journal:  Ann Surg Oncol       Date:  2020-09-03       Impact factor: 5.344

4.  High-volume bariatric surgery in a single center: safety, quality, cost-efficacy and teaching aspects in 2,000 consecutive cases.

Authors:  H J Jacobsen; A Bergland; J Raeder; H G Gislason
Journal:  Obes Surg       Date:  2012-01       Impact factor: 4.129

5.  Pediatric bariatric surgery: the clinical pathway.

Authors:  Aayed R Alqahtani; Mohamed O Elahmedi
Journal:  Obes Surg       Date:  2015-05       Impact factor: 4.129

6.  Understanding how colorectal units achieve short length of stay: an interview survey among representative hospitals in England.

Authors:  Ben E Byrne; Anna Pinto; Paul Aylin; Alex Bottle; Omar D Faiz; Charles A Vincent
Journal:  Patient Saf Surg       Date:  2015-01-23

7.  Korean version of the convalescence and recovery evaluation: translation and linguistic validation.

Authors:  Hyeong Dong Yuk; Julia Jooyoung Kim; Ja Hyeon Ku; Cheol Kwak; Hyeon Hoe Kim; Chang Wook Jeong
Journal:  Prostate Int       Date:  2020-05-27

8.  Impact of quality strategies on hospital outputs.

Authors:  R Suñol; P Vallejo; A Thompson; M J M H Lombarts; C D Shaw; N Klazinga
Journal:  Qual Saf Health Care       Date:  2009-02

9.  Population-based cohort study comparing 30- and 90-day institutional mortality rates after colorectal surgery.

Authors:  B E Byrne; R Mamidanna; C A Vincent; O Faiz
Journal:  Br J Surg       Date:  2013-12       Impact factor: 6.939

10.  Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.

Authors:  Heena P Santry; Scott A Strassels; Angela M Ingraham; Wendelyn M Oslock; Kevin B Ricci; Anghela Z Paredes; Victor K Heh; Holly E Baselice; Amy P Rushing; Adrian Diaz; Vijaya T Daniel; M Didem Ayturk; Catarina I Kiefe
Journal:  BMC Med Res Methodol       Date:  2020-10-02       Impact factor: 4.615

  10 in total

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