Assessing the Quality of Surgical Care in Vascular Surgery; Moving from Outcome Towards Structural and Process Measures

Ploeg, Arianne J.; Flu, Hans C.; Lardenoye, J-W H P; Hamming, Jaap F.; Breslau, Paul J.

doi:10.1016/j.ejvs.2010.05.010

Cited by 18 publications

(16 citation statements)

References 70 publications

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“…This is just the first step in building a robust tool for the future vascular surgical community and there are distinct challenges ahead. The most important conclusion is that the standard of Australasian vascular surgery is high, with excellent outcomes in all the selected areas of audit compared with international data 8 . The outcomes chosen for audit in these four procedures are the best method of assessing the clinical and technical skills of a vascular surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…The most important conclusion is that the standard of Australasian vascular surgery is high, with excellent outcomes in all the selected areas of audit compared with international data. 8 The outcomes chosen for audit in these four procedures are the best method of assessing the clinical and technical skills of a vascular surgeon. Accuracy remains the main challenge for all audits, thus validation of the audit is important in assessing the completeness and quality of the activity.…”

Section: Discussionmentioning

confidence: 99%

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Results from the Australasian Vascular Surgical Audit: the inaugural year

Beiles¹,

Bourke²,

Thomson³

2012

ANZ Journal of Surgery

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The Australian and New Zealand Society for Vascular Surgery has incorporated a constitutional change to administer a self-funded compulsory vascular surgery audit since January 2010. This is a bi-national quality assurance activity that captures all procedures performed in both countries. Data is collected at two points in the clinical admission; at operation and at discharge and data entry is via the Internet. Security is stringent and confidentiality is guaranteed by Commonwealth privilege. Data privacy is maximized by encryption. The application is flexible and administered by a dedicated administrator with a help-desk facility. Reports are available to provide real-time feedback of user performance compared with the peer group data in key categories of arterial surgery. A structured hierarchy for data management has been established to assess four main categories of performance: mortality after aortic surgery, stroke and death after carotid surgery, patency and limb salvage after infrainguinal bypass and patency after arteriovenous access for haemodialysis. Data is analysed using risk-adjustment techniques and an algorithm for management of underperformance has been followed. Data validation has been performed. The outcomes in all categories have been of a high standard and correction of erroneous data in a single statistical outlier has negated underperformance. The audit has captured only 65% of the estimated procedures in Australia in the first year, but data quality is good. The feasibility of a complete compulsory bi-national audit has now been established and will be the benchmark for other craft groups in the current environment of accountability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Results from the Australasian Vascular Surgical Audit: the inaugural year

Beiles¹,

Bourke²,

Thomson³

2012

ANZ Journal of Surgery

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show abstract

“…30 These are essential drivers for development structures and processes required for value creation in based hospital services. 38,39 For decades the relationship between primary care and hospital NHS trusts has been based on block contracts [20][21][22][23][24][25] . This has been a major disincentive to efficient running of hospital care as the sizes of payments were fixed not related to actual productivity.…”

Section: Discussionmentioning

confidence: 99%

Value based healthcare and delivery of vascular surgery services in the United Kingdom

Mofidi

Wong

Gatenby

et al. 2016

Reviews in Vascular Medicine

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“…Donabedian's medical quality model has become a practical and standard framework for medical quality researchers since it was first proposed. Although arguments are still being made about whether it is better to assess medical quality from a process perspective or from an outcome perspective (Feinstein, 2002;Ploeg, Flu, Lardenoye, Hamming, & Breslau, 2010), objective indicator methods, or subjective expert judgments, or patient http://dx.doi.org/10.1016/j.eswa.2015.03.009 0957-4174/Ó 2015 Elsevier Ltd. All rights reserved. feedback have been employed to assess medical quality under Donabedian's framework (Feinstein, 2002;Kerr et al, 2007;Untachai, 2013).…”

Section: Introductionmentioning

confidence: 98%