Clinical quality registries for clinician‐level reporting: strengths and limitations

Ahern, Susannah; Evans, Sue; Hopper, Ingrid; Earnest, Arul

doi:10.5694/mja17.00644

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…Thirty-day readmission rates are increasingly being seen as a performance measure. Overseas, readmission rates are already being publicly reported in some countries and it has been suggested locally that a similar practice could be followed locally [ 5 , 9 ]. Therefore, there is keen interest from clinicians and hospital managers to identify and understand factors associated with 30-day readmission rates.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention

Biswas

Dinh

Lucas

et al. 2020

JCM

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Unplanned readmissions to hospital after percutaneous coronary intervention (PCI) pose a significant burden to the healthcare system and are potentially preventable. In this study, we sought to determine the incidence of, and risk factors for, unplanned hospital readmissions within 30 days following PCI. We prospectively collected data on 28,488 patients undergoing PCI between 2013 and 2019, who were enrolled in the state-wide multi-centre Victorian Cardiac Outcomes Registry. Patients’ data were then linked to data from the Victorian Department of Health administrative database that records statewide hospital admissions. Disease diagnosis codes were used to identify cause of readmission. Patients who had an unplanned readmission were further divided into those who had a cardiac vs. non-cardiac cause for readmission. Overall, 3059 patients (10.7%) had an unplanned hospital readmission within 30 days of PCI, of which 1848 patients (60.4%) were readmitted for primarily cardiac diagnoses. Independent predictors of both 30-day unplanned cardiac and non-cardiac readmissions post-PCI were female sex, having ≥1 admission in the 12 months prior to PCI, acute coronary syndrome presentation, having any in-hospital complication and being discharged on an oral anticoagulant (all p < 0.05). A stepwise increase in readmission risk was observed with increasing number of admissions from 1 to ≥4 admissions in the 12 months prior to PCI. In conclusion, a substantial proportion of patients undergoing PCI have unexpected readmissions to hospital in the 30 days following PCI. Targeted strategies for patients with risk factors for readmission may be useful to reduce this significant burden to the healthcare system.

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Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention

Biswas

Dinh

Lucas

et al. 2020

JCM

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Section: Discussionmentioning

confidence: 99%

“…However, there are risks that should be considered if undertaking clinician level benchmarking, including low procedural volumes and the potential for clinician avoidance of high-risk patients. 28 The Delphi panel endorsed only one process indicator, preoperative intravenous antibiotics. Despite the comparative ease with which process measures are collected at the time of surgery, there is lack of quality data showing a di- rect link with improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

Defining Quality Indicators for Breast Device Surgery: Using Registries for Global Benchmarking

Begum

Vishwanath

Merenda

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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“…Clinical registries play an increasingly important role as a stimulus for quality improvement by providing high-quality data and analyses that are respected by clinicians [ 15 , 16 ]. PROMs in CQRs are used for reporting and benchmarking purposes [ 16 , 17 ]. Implementation of lessons learned from CQRs that include PROMs will assure patients achieve optimal management of the disease and functional gain with minimal adverse events [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Preliminary development of recommendations for the inclusion of patient-reported outcome measures in clinical quality registries

Ruseckaite

Maharaj

Dean

et al. 2022

BMC Health Serv Res

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Background Clinical quality registries (CQRs) monitor compliance against optimal practice and provide feedback to the clinical community and wider stakeholder groups. Despite a number of CQRs having incorporated the patient perspective to support the evaluation of healthcare delivery, no recommendations for inclusion of patient-reported outcome measures (PROMs) in CQRs exist. The aim of this study was to develop a core set of recommendations for PROMs inclusion of in CQRs. Method An online two-round Delphi survey was performed among CQR data custodians, quality of life researchers, biostatisticians and clinicians largely recruited in Australia. A list of statements for the recommendations was identified from a literature and survey of the Australian registries conducted in 2019. The statements were grouped into the following domains: rationale, setting, ethics, instrument, administration, data management, statistical methods, and feedback and reporting. Eighteen experts were invited to participate, 11 agreed to undertake the first online survey (round 1). Of these, nine experts completed the online survey for round 2. Results From 117 statements presented to the Delphi panel in round 1, a total of 72 recommendations (55 from round 1 and 17 from round 2) with median importance (MI) ≥ 7 and disagreement index (DI) < 1 were proposed for inclusion into the final draft set and were reviewed by the project team. Recommendations were refined for clarity and to read as stand-alone statements. Ten overlapped conceptually and, therefore, were merged to reduce repetition. The final 62 recommendations were sent for review to the panel members for their feedback, which was incorporated into the final set. Conclusion This is the first study to develop preliminary recommendations for PROMs inclusion in CQRs. Recommendations for PROMs implementation are critically important for registries to assure meaningful PROMs data capture, use, interpretation, and reporting to improve health outcomes and healthcare value.

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Clinical quality registries for clinician‐level reporting: strengths and limitations

Cited by 8 publications

References 5 publications

Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention

Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention

Defining Quality Indicators for Breast Device Surgery: Using Registries for Global Benchmarking

Preliminary development of recommendations for the inclusion of patient-reported outcome measures in clinical quality registries

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