Shaping quality: the use of performance polygons for multidimensional presentation and interpretation of qualitative performance data

Cook, Tim; Coupe, Michael; Ku, Tae Geom

doi:10.1093/bja/aes026

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…Additional representations of the types of comparative information should be tested to further understand the impact on quality judgment. For example, performance polygons have been suggested as another way to present component quality measures [44]. We also only provided two filters to interrogate the component measures when judging quality of hypertension care (diabetes and low income patients only).…”

Section: Discussionmentioning

confidence: 99%

Effect of Pooled Comparative Information on Judgments of Quality

Baumgart

Bass

Voss

et al. 2015

IEEE Trans. Human-Mach. Syst.

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Quality assessment is the focus of many health care initiatives. Yet it is not well understood how the type of information used in decision support tools to enable judgments of quality based on data impacts the accuracy, consistency and reliability of judgments made by physicians. Comparative pooled information could allow physicians to judge the quality of their practice by making comparisons to other practices or other specific populations of patients. In this study, resident physicians were provided with varying types of information derived from pooled patient data sets: quality component measures at the individual and group level, a qualitative interpretation of the quality measures using percentile rank, and an aggregate composite quality score. 32 participants viewed thirty quality profiles consisting of information applicable to the practice of thirty de-identified resident physicians. Those provided with quality component measures and a qualitative interpretation of the quality measures (rankings) judged quality of care more similarly to experts and were more internally consistent compared to participants who were provided with quality component measures alone. Reliability between participants was significantly less for those who were provided with a composite quality score compared to those who were not.

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Section: Discussionmentioning

confidence: 99%

Effect of Pooled Comparative Information on Judgments of Quality

Baumgart

Bass

Voss

et al. 2015

IEEE Trans. Human-Mach. Syst.

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“…This necessitates specific measures. There are various methods for monitoring anaesthesia care [65][66][67][68][69][70] , some of which have been more vigorously investigated than others. Whilst they can be used to improve performance, none are yet suitable for high-stakes decisions 71 .…”

Section: Is There An Issue With Australian Anaesthetists' Performance?mentioning

confidence: 99%

Revalidation: Implications for Australian Anaesthetists

Roberts

2015

Anaesth Intensive Care

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In early 2015, the Medical Board of Australia commissioned research into international revalidation models and what might be applicable for Australia. This review examines the implications for Australian anaesthetists. What problem is revalidation seeking to address? What is happening in similar countries? Is there an issue with Australian anaesthetists' performance? Isn't continuing professional development enough? Could the Medical Board target known high-risk doctors? What is the evidence for the benefit of revalidation? How is and how should the profession be involved? Revalidation has been introduced in other developed countries. It commonly involves continuing professional development, feedback from colleagues, co-workers and patients, clinical audit and peer review. Although its evidence base is limited, the General Medical Council in the United Kingdom is evaluating its revalidation system, which should provide useful guidance for other countries. Australian anaesthetists and their professional organisations must remain informed about, and engaged in, the national debate about revalidation, to ensure that any new process is workable for Australian anaesthesia practice.

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“…In addition to patient suffering, postoperative pain can also affect quality of recovery after surgical procedures [4][5][6] . It is likely, therefore, that strategies that improve postoperative pain can also ameliorate postsurgical recovery [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Transversus abdominis plane infiltration for laparoscopic gastric banding: A pilot study

Oliveira

Fitzgerald

Ahmad

et al. 2014

WJGS

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AIM:To estimate an effect size for the transversus abdominis plane (TAP) infiltration on quality of recovery in patients undergoing laparoscopic gastric band surgery. METHODS:The pilot study was a randomized, double blinded, placebo controlled trial. Patients undergoing laparoscopic gastric band surgery were randomized to receive a bilateral TAP infiltration with 20 mL of 0.5% ropivacaine or saline. The evaluated outcomes included quality of recovery-40 (QoR-40) at 24 h, postoperative opioid consumption and pain. Data was examined using the Mann-Whitney U test. RESULTS:Nineteen subjects were recruited. There was a positive trend favoring the TAP infiltration group in global QoR-40 scores at 24 h after surgery, median [interquartile range (IQR)] of 175.5 (170-189) compared to 170 (160-175) in the control group (P = 0.06). There also a positive trend toward a lower cumulative opioid consumption in the TAP infiltration group, median (IQR) of 7.5 (2.5-11.5) mg iv morphine equivalents compared to 13 (7-21.5) in the control group (P = 0.07). Correlation analysis (Spearman's Rho) demonstrated an inverse relationship between 24 h cumulative opioid consumption and global QoR-40 scores, -0.49 (P = 0.03). CONCLUSION:The use of multimodal analgesic techniques to reduce opioid related side effects is particularly desirable in morbidly obese patients undergoing gastric reduction surgery. The TAP infiltration seems to have a clinically important effect in reducing postoperative opioid consumption and improve quality of recovery after laparoscopic gastric band surgery in morbid obese patients. Future studies to confirm the beneficial effects of the TAP infiltration in these patients are warranted.© 2014 Baishideng Publishing Group co., Limited. All rights reserved.Key words: Transversus abdominis plane; Infiltration; Gastric band; Pain; Recovery Core tip: In this current randomized, double blinded, placebo controlled pilot study we estimated the effect of a transversus abdominis plane block on postoperative quality of recovery in morbidly obese patients undergoing laparoscopic gastric band surgery. Postoperative opioid consumption was inversely correlated to quality of recovery in this surgical population. The transversus abdominis plane block seems to be an effective strategy to improve quality of recovery in those patients.

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Shaping quality: the use of performance polygons for multidimensional presentation and interpretation of qualitative performance data

Abstract: Performance polygons enable easy comparison with any relevant data set and are a visual tool that potentially has wider applications in healthcare quality improvement.

Cited by 8 publications

References 10 publications

Effect of Pooled Comparative Information on Judgments of Quality

Effect of Pooled Comparative Information on Judgments of Quality

Revalidation: Implications for Australian Anaesthetists

Transversus abdominis plane infiltration for laparoscopic gastric banding: A pilot study

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