Association of Surgical Care Improvement Project Infection-Related Process Measure Compliance with Risk-Adjusted Outcomes: Implications for Quality Measurement

Ingraham, Angela M.; Cohen, Mark E.; Bilimoria, Karl Y.; Dimick, Justin B.; Richards, Karen; Raval, Mehul V.; Fleisher, Lee A.; Hall, Bruce L.; Ko, Clifford Y.

doi:10.1016/j.jamcollsurg.2010.09.006

Cited by 154 publications

(96 citation statements)

References 27 publications

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“…Consistent with recent studies [8][9][10] , we did not find any significant effect on postoperative infections due to hospital compliance with SCIP infection prevention measures. Instead, we found an association between hospital compliance with VTE prevention measures and higher levels or risks of postoperative infections.…”

Section: Discussionsupporting

confidence: 92%

“…SCIP VTE-2 measures the percentage of hospital patients who received appropriate venous thromboembolism prophylaxis (except aspirin) within twenty-four hours before surgery to twenty-four hours after surgery. SCIP measures against infections have been evaluated recently in a multi-institutional setting with minimal reduction in infections identified [8][9][10] . Process measures related to VTE prophylaxis are not without controversy.…”

mentioning

confidence: 99%

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Compliance with Surgical Care Improvement Project Measures and Hospital-Associated Infections Following Hip Arthroplasty

Wang

Chen

Ward

et al. 2012

Journal of Bone and Joint Surgery

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Compliance with Surgical Care Improvement Project Measures and Hospital-Associated Infections Following Hip Arthroplasty

Wang

Chen

Ward

et al. 2012

Journal of Bone and Joint Surgery

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“…28 Fewer studies have investigated the association between early readmission and overall patient survival in a surgical cohort. 18 Our study is the first to consider an internal cohort to investigate the correlation between early readmission and survival in patients with newly diagnosed glioblastoma undergoing a craniotomy. We have shown that an unplanned readmission within 30 days of discharge is associated with a 9-month survival reduction (p = 0.003), consistent with previous studies reporting that readmission within 30 days of surgery is associated with poorer overall survival in hepatopancreatobiliary, thyroid, and pancreatic malignancies.…”

Section: Fig 1 Overall Survival (Os) Functions For 327 Non-readmittmentioning

confidence: 99%

Unplanned readmissions and survival following brain tumor surgery

Dickinson¹,

Carico²,

Nuño³

et al. 2015

JNS

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OBJect Research on readmissions has been influenced by efforts to reduce hospital cost and avoid penalties stipulated by the Centers for Medicare and Medicaid Services. Less emphasis has been placed on understanding these readmissions and their impact on patient outcomes. This study 1) delineates reasons for readmission, 2) explores factors associated with readmissions, and 3) describes their impact on the survival of glioblastoma patients. MetHODS The authors conducted a retrospective review of 362 cases involving patients with glioblastoma undergoing biopsy or tumor resection at their institution between 2003 and 2011. Reasons for re-hospitalization were characterized according to whether or not they were related to surgery and considered preventable. Multivariate analyses were conducted to identify the effect of readmission on survival and determine factors associated with re-hospitalizations. reSultS Twenty-seven (7.5%) of 362 patients experienced unplanned readmissions within 30 days of surgery. Six patients (22.2%) were readmitted by Day 7, 14 (51.9%) by Day 14, and 20 (74.1%) by Day 21. Neurological, infectious, and thromboembolic complications were leading reasons for readmission, accounting for, respectively, 37.0%, 29.6%, and 22.2% of unplanned readmissions. Twenty-one (77.8%) of the 27 readmissions were related to surgery and 19 (70.4%) were preventable. The adjusted hazard ratio of mortality associated with a readmission was 2.03 (95% CI 1.3-3.1). Higher-functioning patients (OR 0.96, 95% CI 0.9-1.0) and patients discharged home (OR 0.21, 95% CI 0.1-0.6) were less likely to get readmitted. cOncluSiOnS An overwhelming fraction of documented unplanned readmissions were considered preventable and related to surgery. Patients who were readmitted to the hospital within 30 days of surgery had twice the risk of mortality compared with patients who were not readmitted.http://thejns.org/doi/abs/10.3171/2014.8.JNS1498Key WOrDS unplanned readmission; glioblastoma; complications; functional status; oncology aBBreviatiOnS DVT = deep venous thrombosis; HR = hazard ratio; KPS = Karnofsky Performance Status; LOS = length of hospital stay; PE = pulmonary embolism; SOI = severity of illness; SSI = surgical site infection; UTI = urinary tract infection; VTE = venous thromboembolism.

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“…Although some studies have not shown an association between improved outcomes and higher performance on quality measures, we would like to look at this more closely in the stroke population. 19 As our database gets larger, we would like to reexamine our findings after correcting for more specific characteristics of each hospital. In the future, if additional states designate centers by level of stroke care, it will be important to compare how such designations compare to nonprofit organization certifications in terms of impacting performance on a larger scale.…”

Section: Discussionmentioning

confidence: 99%

“…CSCs adhered better to 6 of the 8 JC measures than PSCs. Of eligible patients, 19.5% received thrombolytic therapy at CSCs compared to 9.6% at PSCs, with a 44% difference in provision of thrombolytic therapy (aOR 5 0.28, 95% confidence interval: 0.24-0.34). Median door-tothrombolytic drug times was 65 minutes at CSCs compared to 74.0 minutes at PSCs (P < 0.0001).…”

Section: Methodsmentioning

confidence: 99%

Compliance with joint commission measures in state-designated stroke centers

et al. 2013

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BACKGROUND Comparison of state‐designated primary and comprehensive stroke centers (PSCs and CSCs) with regard to adherence to nationally accepted performance standards are scarce. The objective of this study was to examine if a significant association exists between level of designation and fulfillment of Joint Commission (JC) stroke core measures. METHODS A retrospective comparative data analysis of the New Jersey acute stroke registry for the calendar years 2010 and 2011 was performed. JC core measures were compared by hospital level (PSCs vs CSCs). Adjusted odds ratios (aOR) were estimated for association between hospital levels and fulfillment of JC core measures. Median door‐to‐thrombolytic time was also compared. RESULTS There were 36,892 acute stroke admissions. PSCs had 60% of the patients, whereas CSCs had 40%. Hemorrhagic stroke admissions were about 2 times more frequent at CSCs than PSCs (13.3% and 7.1%, respectively). CSCs adhered better to 6 of the 8 JC measures than PSCs. Of eligible patients, 19.5% received thrombolytic therapy at CSCs compared to 9.6% at PSCs, with a 44% difference in provision of thrombolytic therapy (aOR = 0.28, 95% confidence interval: 0.24‐0.34). Median door‐to‐thrombolytic drug times was 65 minutes at CSCs compared to 74.0 minutes at PSCs (P < 0.0001). CONCLUSIONS New Jersey state‐designated CSCs are better at adhering to the JC core stroke measures and have shorter door‐to‐thrombolytic drug times. Journal of Hospital Medicine 2014;9:88–93. © 2013 Society of Hospital Medicine

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Association of Surgical Care Improvement Project Infection-Related Process Measure Compliance with Risk-Adjusted Outcomes: Implications for Quality Measurement

Cited by 154 publications

References 27 publications

Compliance with Surgical Care Improvement Project Measures and Hospital-Associated Infections Following Hip Arthroplasty

Compliance with Surgical Care Improvement Project Measures and Hospital-Associated Infections Following Hip Arthroplasty

Unplanned readmissions and survival following brain tumor surgery

Compliance with joint commission measures in state-designated stroke centers

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