National Pediatric Anesthesia Safety Quality Improvement Program in the United States

2014 ◽  
Vol 119 (1) ◽  
pp. 112-121 ◽  
Author(s):  
C. Dean Kurth ◽  
Don Tyler ◽  
Eugenie Heitmiller ◽  
Steven R. Tosone ◽  
Lynn Martin ◽  
...  
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Pediatric Anesthesia ◽  
The United States ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Anesthesia Safety

National Pediatric Anesthesia Safety Quality Improvement Program in the United States

2015 ◽  
Vol 59 (1) ◽  
pp. 36-37
Author(s):  
C. Dean Kurth ◽  
Don Tyler ◽  
Eugenie Heitmiller ◽  
Steven R. Tosone ◽  
Lynn Martin ◽  
...  
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Pediatric Anesthesia ◽  
The United States ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Anesthesia Safety

Accuracy of the ACS NSQIP Online Risk Calculator Depends on How You Look at It: Results from the United States Gastric Cancer Collaborative

2018 ◽  
Vol 84 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Eliza W. Beal ◽  
Neil D. Saunders ◽  
Joseph F. Kearney ◽  
Ezra Lyon ◽  
Lai Wei ◽  
...  
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Quality Improvement ◽  
The United States ◽  
Quality Improvement Program ◽  
Risk Calculator ◽  
Improvement Program ◽  
Surgical Quality ◽  
Online Risk ◽  
American College Of Surgeons

The objective of this study is to assess the accuracy of the American College of Surgeons National Surgical Quality Improvement Program online risk calculator for estimating risk after operation for gastric cancer using the United States Gastric Cancer Collaborative. Nine hundred and sixty-five patients who underwent resection of gastric adenocarcinoma between January 2000 and December 2012 at seven academic medical centers were included. Actual complication rates and outcomes for patients were compared. Most of the patients underwent total gastrectomy with Roux-en-Y reconstruction (404, 41.9%) and partial gastrectomy with gastrojejunostomy (239, 24.8%) or Roux-en-Y reconstruction (284, 29.4%). The C-statistic was highest for venous throm-boembolism (0.690) and lowest for renal failure at (0.540). All C-statistics were less than 0.7. Brier scores ranged from 0.010 for venous thromboembolism to 0.238 for any complication. General estimates of risk for the cohort were variable in terms of accuracy. Improving the ability of surgeons to estimate preoperative risk for patients is critically important so that efforts at risk reduction can be personalized to each patient. The American College of Surgeons National Surgical Quality Improvement Program risk calculator is a rapid and easy-to-use tool and validation of the calculator is important as its use becomes more common.

Availability of Inpatient Pediatric Surgery in the United States

2021 ◽  
Author(s):  
Michael L. McManus ◽  
Urbano L. França
Keyword(s):  
Quality Improvement ◽  
Pediatric Surgery ◽  
Surgical Care ◽  
The United States ◽  
Quality Improvement Program ◽  
Care Hospital ◽  
Improvement Program ◽  
Data Set ◽  
American College Of Surgeons ◽  
Verification Quality

Background In 2015, the American College of Surgeons began its Children’s Surgery Verification Quality Improvement Program, promulgating standards intended to promote regionalization and improve pediatric surgical care. It was hypothesized that pediatric surgical care was already highly regionalized and concentrated before implementation of the program. This study aimed to demonstrate this by describing the sites and volume of nonambulatory pediatric surgery. Methods A two-part, retrospective, cross-sectional analysis was performed. First, six all-encounter state inpatient data sets (Arkansas, Florida, Kentucky, Maryland, and New York from the Healthcare Cost and Utilization Project and Massachusetts from the Center for Health Information) were used to evaluate all procedures performed within specific hospitals in 2014. Next, a national sample data set (2016 Kids’ Inpatient Database) was used to determine the generalizability of the single state results. All acute care hospital admissions for patients less than 18 yr of age were included to describe the nature and location of all surgical procedures therein by patient age, surgical specialty, procedure type, and hospital service breadth. Results Within the six study states, there were 713 hospitals, of which 635 (89.1%) admitted patients less than 18 yr old, and 516 (72.4%) reported pediatric procedures. Among these, there were 9 specialty hospitals and 39 hospitals with services comparable to independent children’s hospitals. Of 153,587 procedures among 1,065,655 pediatric admissions, 127,869 (83.3%) took place within these 48 centers. This fraction decreased with age (89.9% of patients less than 2 yr old and 68.5% of 15- to 17-yr-olds), varied slightly by specialty, and was similar across states. Outside of specialized centers, teenagers accounted for 47.4% of all procedures. Within the national data sample, the concentration was similar: 8.7% (328 of 3,777) of all hospitals admitting children were responsible for 90.1% (793,905 of 881,049) of all procedures, with little regional variation. Conclusions Before the American College of Surgeons Children’s Surgery Verification Quality Improvement Program, the vast majority of pediatric nonambulatory surgeries were already confined to a small subset of high-capability and specialty centers. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Quality Improvement on an Academic Autopsy Service

2001 ◽  
Vol 125 (2) ◽  
pp. 237-245 ◽  
Author(s):  
John H. Sinard ◽  
Deborah J. Blood
Keyword(s):  
Quality Improvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Physician Satisfaction ◽  
Quality Improvement Program ◽  
Autopsy Rate ◽  
Quality Of Data ◽  
Improvement Program

Abstract Context.—Autopsy rates continue to decline in the United States. Objective.—Although many of the causes of this decline are external to pathology departments, we hypothesized that intradepartmental efforts to improve the quality of the service we provide to our clinical colleagues could increase our autopsy rate. Method.—We developed a multifaceted quality improvement program for our autopsy service aimed at increasing the visibility of the service, improving the service's reporting, and increasing the amount and quality of data available from the service. Setting.—A large academic medical center that performs approximately 250 autopsies each year. Results.—After implementation of our quality improvement program, the decline in our autopsy rate has not only stopped, but rates have even begun to increase. Additionally, physician satisfaction surveys conducted before and after implementation of our quality improvement initiatives showed an across-the-board improvement in clinician perception of the service. Conclusion.—Pathologists can and should be proactive in addressing the declining autopsy rate, rather than viewing it as someone else's problem or hoping that someone else will protect this important quality assurance tool for medical care.

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