Lori A Gurien1, Jin H Ra2, Andrew J Kerwin2, Michael S Nussbaum2, Marie Crandall2, Jhun deVilla2, Joseph J Tepas2. 1. Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA. Electronic address: lgurien@gmail.com. 2. Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA.
Abstract
BACKGROUND: Morbidity and Mortality conference (M&M) and the National Surgical Quality Improvement Program (NSQIP) are systems to improve surgical care. We evaluated the commonality of adverse events (AEs) and the change in AE rates after integration. METHODS: A single institution's NSQIP and M&M registries were analyzed to determine commonality of AE reported. Causal determinant groups were then created to categorize and standardize AE. Incidence of AE and patient commonality identified by these systems was evaluated over 2 years. RESULTS: The 68 common patients identified in 2012 represented 27% of NSQIP and 43% of M&M patients. Common AE reported by M&M and NSQIP decreased from 16.9% (2013) to 9.6% (2014). Causality code analysis demonstrated significant differences in proportion of issues addressed within each (P < .0001). CONCLUSIONS: Despite standardized coding, M&M focus differed from NSQIP. Low commonality affirms NSQIP as a critical adjunct to voluntary reporting. Combining both may help eliminate preventable AEs.
BACKGROUND: Morbidity and Mortality conference (M&M) and the National Surgical Quality Improvement Program (NSQIP) are systems to improve surgical care. We evaluated the commonality of adverse events (AEs) and the change in AE rates after integration. METHODS: A single institution's NSQIP and M&M registries were analyzed to determine commonality of AE reported. Causal determinant groups were then created to categorize and standardize AE. Incidence of AE and patient commonality identified by these systems was evaluated over 2 years. RESULTS: The 68 common patients identified in 2012 represented 27% of NSQIP and 43% of M&M patients. Common AE reported by M&M and NSQIP decreased from 16.9% (2013) to 9.6% (2014). Causality code analysis demonstrated significant differences in proportion of issues addressed within each (P < .0001). CONCLUSIONS: Despite standardized coding, M&M focus differed from NSQIP. Low commonality affirms NSQIP as a critical adjunct to voluntary reporting. Combining both may help eliminate preventable AEs.
Authors: Joel Zindel; Reto M Kaderli; Manuel O Jakob; Michel Dosch; Franziska Tschan; Daniel Candinas; Guido Beldi Journal: World J Surg Date: 2018-11 Impact factor: 3.352