Statistical approach to quality assessment in liver transplantation

Schrem, Harald; Volz, S.; Koch, H; Gwiasda, Jill; Kürsch, Priscila; Goldis, Alon; Pöhnert, Daniel; Winny, Markus; Klempnauer, Jürgen; Kaltenborn, Alexander

doi:10.1007/s00423-017-1612-7

Cited by 7 publications

(2 citation statements)

References 18 publications

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“…Schrem et al 39 used CUSUM charts to retrospectively analyse liver transplant mortality results after a perceived increase. 40 They aimed to identify outliers and specific causes and effects for these results from a single centre.…”

Section: Transplantationmentioning

confidence: 99%

Use of statistical process control in quality improvement projects in abdominal surgery: a PRISMA systematic review

Lima de Mendonca,

Sarto,

Titeca

et al. 2024

BMJ Open Qual

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BackgroundThe use of quality improvement methodology has increased in recent years due to a perceived benefit in effectively reducing morbidity, mortality and length of stay. Statistical process control (SPC) is an important tool to evaluate these actions, but its use has been limited in abdominal surgery. Previous systematic reviews have examined the use of SPC in healthcare, but relatively few surgery-related articles were found at that time.ObjectiveTo perform a systematic review (SR) to evaluate the application of SPC on abdominal surgery specialties between 2004 and 2019.MethodsAn SR following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram was completed using Embase and Ovid Medline with terms related to abdominal surgery and SPC.ResultsA total of 20 articles were selected after applying the exclusion criteria. Most of the articles came from North America, Europe and Australia, and half have been published in the last 5 years. The most common outcome studied was surgical complications. Urology, colorectal and paediatric surgery made up most of the articles. Articles show the application of SPC in various outcomes and the use of different types of graphs, demonstrating flexibility in using SPC. However, some studies did not use SPC in a robust way and these studies were of variable quality.ConclusionThis study shows that SPCs are being applied increasingly for most surgical specialties; however, it is still less used than in other fields, such as anaesthesia. We identified conceptual errors in several studies, such as issues with the design or incorrect data analysis. SPCs can be used to increase the quality of surgical care; the use should increase, but critically, the analysis needs to improve to prevent erroneous conclusions being drawn.

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Section: Transplantationmentioning

confidence: 99%

Use of statistical process control in quality improvement projects in abdominal surgery: a PRISMA systematic review

Lima de Mendonca,

Sarto,

Titeca

et al. 2024

BMJ Open Qual

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“…Under this system, quality monitoring reports are used to both regulate transplant programs and inform the public about transplant center performance. Various methods for monitoring transplant quality are being discussed in other countries ; the development of such systems could be informed by the experiences of transplant centers in the United States.…”

Section: Introductionmentioning

confidence: 99%

Reported effects of the Scientific Registry of Transplant Recipients 5-tier rating system on US transplant centers: results of a national survey

et al. 2018

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In the United States, the Scientific Registry of Transplant Recipients (SRTR) provides publicly available quality report cards. These reports have historically rated transplant programs using a 3-tier system. In 2016, the SRTR temporarily transitioned to a 5-tier system, which classified more programs as under-performing. As part of a larger survey about transplant quality metrics, we surveyed members of the American Society of Transplant Surgeons and American Society of Transplantation (N = 280 respondents) on transplant center experiences with patient and payer responses to the 5-tier SRTR ratings. Over half of respondents (n = 137, 52.1%) reported ≥1 negative effect of the new 5-tier ranking system, including losing patients, losing insurers, increased concern among patients, and increased concern among referring providers. Few respondents (n = 35, 13.7%) reported any positive effects of the 5-tier ranking system. Lower SRTR-reported scores on the 5-tier scale were associated with increased risk of reporting at least one negative effect in a logistic model (P < 0.01). The change to a more granular rating system provoked an immediate response in the transplant community that may have long-term implications for transplant hospital finances and patient options for transplantation.

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