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[A method for quality assurance of surgical urologic training. Decentralized registration with centralized statistical processing].

https://arctichealth.org/en/permalink/ahliterature201910
Source
Ugeskr Laeger. 1999 Apr 5;161(14):2086-9
Publication Type
Article
Date
Apr-5-1999

Are complication rates for elective primary total hip arthroplasty in Ontario related to surgeon and hospital volumes? A preliminary investigation.

https://arctichealth.org/en/permalink/ahliterature203630
Source
Can J Surg. 1998 Dec;41(6):431-7
Publication Type
Article
Date
Dec-1998
Author
H J Kreder
J I Williams
S. Jaglal
R. Hu
T. Axcell
D. Stephen
Author Affiliation
Division of Orthopedic Surgery, University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Ont. hans@ices.on.ca
Source
Can J Surg. 1998 Dec;41(6):431-7
Date
Dec-1998
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - statistics & numerical data - utilization
Cohort Studies
Comorbidity
Databases, Factual
Diagnosis-Related Groups
Female
Humans
Length of Stay
Male
Mortality
Ontario - epidemiology
Patient Readmission - statistics & numerical data
Postoperative Complications - epidemiology - etiology - mortality
Quality of Health Care - statistics & numerical data
Sex Factors
Surgery Department, Hospital - standards - statistics & numerical data - utilization
Surgical Procedures, Elective - standards - statistics & numerical data - utilization
Abstract
To test the hypothesis that complication rates for elective total hip replacement operations are related to surgeon and hospital volumes.
Retrospective population cohort study. STUDY COHORT: Patients who had undergone elective total hip replacement in Ontario during 1992 as captured in the Canadian Institute for Health Information database.
In-hospital complications, 1- and 3-year revision rates, 1- and 3-year infection rates, length of hospital stay, and 3-month and 1-year death rates.
Surgeons with patient volumes above the 80th percentile (more than 27 hip replacements annually) discharged patients approximately 2.4 days earlier (p 0.05).
There is no evidence to support regionalization of elective hip replacement surgery in Ontario based on adverse clinical outcomes. Surgeons who perform a large number of total hip replacements are discharging patients earlier than less experienced surgeons, without any-demonstrable increase in complications leading to hospital readmission. The explanation for this observation remains unknown and will require further study.
PubMed ID
9854532 View in PubMed
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Hospital Surgical Volumes and Mortality after Coronary Artery Bypass Grafting: Using International Comparisons to Determine a Safe Threshold.

https://arctichealth.org/en/permalink/ahliterature282323
Source
Health Serv Res. 2017 Apr;52(2):863-878
Publication Type
Article
Date
Apr-2017
Author
Nils Gutacker
Karen Bloor
Richard Cookson
Chris P Gale
Alan Maynard
Domenico Pagano
José Pomar
Enrique Bernal-Delgado
Source
Health Serv Res. 2017 Apr;52(2):863-878
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Coronary Artery Bypass - mortality - standards
Denmark - epidemiology
Diagnosis-Related Groups
England - epidemiology
Female
Hospital Mortality
Humans
Male
Middle Aged
Portugal - epidemiology
Slovenia - epidemiology
Spain - epidemiology
Surgery Department, Hospital - standards - statistics & numerical data
Surgical Procedures, Operative - statistics & numerical data
Abstract
To estimate a safe minimum hospital volume for hospitals performing coronary artery bypass graft (CABG) surgery.
Hospital data on all publicly funded CABG in five European countries, 2007-2009 (106,149 patients).
Hierarchical logistic regression models to estimate the relationship between hospital volume and mortality, allowing for case mix. Segmented regression analysis to estimate a threshold.
The 30-day in-hospital mortality rate was 3.0 percent overall, 5.2 percent (95 percent CI: 4.0-6.4) in low-volume hospitals, and 2.1 percent (95 percent CI: 1.8-2.3) in high-volume hospitals. There is a significant curvilinear relationship between volume and mortality, flatter above 415 cases per hospital per year.
There is a clear relationship between hospital CABG volume and mortality in Europe, implying a "safe" threshold volume of 415 cases per year.
Notes
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PubMed ID
27198068 View in PubMed
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[Infection registration underestimates the frequency of surgical wound infection]

https://arctichealth.org/en/permalink/ahliterature72623
Source
Ugeskr Laeger. 1998 Jan 19;160(4):421-4
Publication Type
Article
Date
Jan-19-1998
Author
K B Poulsen
M. Meyer
Author Affiliation
Den centrale afdeling for sygehushygiejne, Statens Serum Institut, København.
Source
Ugeskr Laeger. 1998 Jan 19;160(4):421-4
Date
Jan-19-1998
Language
Danish
Publication Type
Article
Keywords
Adult
Cross-Sectional Studies
Denmark - epidemiology
English Abstract
Female
Follow-Up Studies
Humans
Male
Obstetrics and Gynecology Department, Hospital - standards - statistics & numerical data
Prospective Studies
Questionnaires
Registries
Surgery Department, Hospital - standards - statistics & numerical data
Surgical Wound Infection - epidemiology
Abstract
Two consecutive bedside prevalence studies of 455 surgical patients were made by the same infection control nurse in 15 surgical and gynaecological departments in eight Danish hospitals. Four point six percent had a deep and another 4.6% a superficial surgical wound infection (SWI). Two months after the second survey only one third of the infections were correctly recorded by the hospital routine surveillance of surgical wound infections (SWI). Registration systems that are simpler and more valid than the existing ones need to be developed. A follow-up was carried out with self-administered questionnaires in 2976 patients, of whom 1447 (48.6%) responded. A patient-diagnosed SWI was defined as an antibiotic treatment of a wound and/or a wound reopening by a health care professional. A total of 311 patients were treated for a SWI, 42% with antibiotics, 27% with wound reopening and 31% received both these treatments. Post-discharge surveillance cannot be recommended as a routine.
PubMed ID
9463254 View in PubMed
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[Patient satisfaction--a study of patients' assessment of the treatment at a department of orthopedic surgery].

https://arctichealth.org/en/permalink/ahliterature219612
Source
Ugeskr Laeger. 1993 Dec 20;155(51):4162-5
Publication Type
Article
Date
Dec-20-1993
Author
P. Jensen
L M Haugegaard
H. Thomsen
O. Roikjaer
Author Affiliation
Ortopaedkirurgisk afdeling, Centralsygehuset i Naestved.
Source
Ugeskr Laeger. 1993 Dec 20;155(51):4162-5
Date
Dec-20-1993
Language
Danish
Publication Type
Article
Keywords
Denmark
Humans
Orthopedic Nursing - standards - statistics & numerical data
Orthopedics - standards - statistics & numerical data
Patient Education as Topic - standards
Patient satisfaction
Postoperative Care - standards
Questionnaires
Surgery Department, Hospital - standards - statistics & numerical data
Abstract
A study among day-case and inpatients on an orthopaedic ward has been carried out to assess patient satisfaction. A single-page questionnaire were mailed to 445 patients, 388 (87.2%) returned the questionnaire. Three hundred and fifty five (79.8%) answers were usable. We found an overall rate of satisfaction with the given treatment of 71.3%, 20.3% were dissatisfied. We found the group of day-case patients more satisfied than the group of inpatients. The group of patients who underwent arthroscopic surgery were identified as being the most dissatisfied. There were among all patients a large group who were dissatisfied with the amount of perioperative information and especially the amount of postoperative out-patient control. We recommend a higher degree of written information including information about risk of complications and failures.
PubMed ID
8273239 View in PubMed
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[Productivity in a Norwegian department of surgery].

https://arctichealth.org/en/permalink/ahliterature214536
Source
Tidsskr Nor Laegeforen. 1995 Aug 20;115(19):2402-5
Publication Type
Article
Date
Aug-20-1995
Author
T M Hoel
P A Steen
Author Affiliation
Anestesiavdelingen Sentralsykehuset i Akershus, Nordbyhagen.
Source
Tidsskr Nor Laegeforen. 1995 Aug 20;115(19):2402-5
Date
Aug-20-1995
Language
Norwegian
Publication Type
Article
Keywords
Efficiency
Humans
Length of Stay
Norway
Surgery Department, Hospital - standards - statistics & numerical data
Time Factors
Abstract
There are few good methods of evaluating efficiency in the operating theatres. Data from four operating theatres (gynaecology, gastroenterology, thoracic/vascular-surgery and orthopaedics) during regular working hours (0730-1530) were evaluated for a period of 37 weeks in 1993. A record was made of duration of surgery and the time that elapsed from when the nurses received the patient until he or she was delivered to the postoperative ward. We also registered the time elapsing from the end of one operation to the start of the next. On average 2.2 (thoracic/vascular) to 3.2 (gynaecology) patients were operated on each day. The surgeons spent about 40% of their normal working hours actually operating. Preparations before start of anaesthesia took about 30 minutes, and before surgery 30-40 minutes. Another 30 minutes elapsed from the end of the operation until the patient was delivered to the postoperative ward. We conclude that there may still be a potential for increasing productivity in these operating theatres.
Notes
Comment In: Tidsskr Nor Laegeforen. 1995 Nov 20;115(28):35497491611
PubMed ID
7667859 View in PubMed
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[Quality assurance of antibiotic therapy at the Hvidovre Hospital. Results of an audit project].

https://arctichealth.org/en/permalink/ahliterature203994
Source
Ugeskr Laeger. 1998 Oct 26;160(44):6345-8
Publication Type
Article
Date
Oct-26-1998

[Quality monitoring of colon surgeons' volume of operations]

https://arctichealth.org/en/permalink/ahliterature16644
Source
Ugeskr Laeger. 2005 Nov 7;167(45):4277-9
Publication Type
Article
Date
Nov-7-2005
Author
Anders Onsberg Hansen
Hans Okkels Birk
Author Affiliation
Roskilde Amt, Sundhedsforvaltningen. anders_onsberg@tele2adsl.dk
Source
Ugeskr Laeger. 2005 Nov 7;167(45):4277-9
Date
Nov-7-2005
Language
Danish
Publication Type
Article
Keywords
Clinical Competence
Colon - surgery
Colorectal Neoplasms - surgery
Colorectal Surgery - statistics & numerical data
Denmark - epidemiology
English Abstract
Humans
Postoperative Complications - diagnosis - epidemiology
Quality Assurance, Health Care
Questionnaires
Rectum - surgery
Registries
Surgery Department, Hospital - standards - statistics & numerical data
Treatment Outcome
Workload - statistics & numerical data
Abstract
INTRODUCTION: The number of operations performed by a surgeon is a predictor of the outcome of colon/rectum resection. Therefore it is relevant to monitor the surgeons' volume of work and the number of patients' complications in order to secure both an adequate number and high quality. MATERIALS AND METHODS: Using data from the Danish National Patient Registry and Danish Colon Cancer Group's database, we located hospital departments that had performed colon/rectum surgery in 2003 and asked them whether they monitored surgeons' volume of work and the number of patients' complications and whether they considered those data relevant to the patients or their GPs. RESULTS: Thirty-nine departments had performed colon/rectum resection; 27 of them responded. Eight departments (36%) had defined a standard for the number of operations per surgeon, while only four used the data to determine the surgeons' volume of work. 68% found data concerning the department's volume of operations relevant to both GPs and patients, while 23% thought that those data were not relevant to GPs or patients. 64% found the data concerning surgeons' volume to be irrelevant to both GPs and patients. None of the departments had informed the GPs or the patients about their results. DISCUSSION: It is remarkable that very few hospital departments actually collect and use data to secure adequate volume and quality. It is necessary to increase the focus on surgeons' volume of operations in order to secure high quality.
PubMed ID
16277929 View in PubMed
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[Quality of data on computerized registration of postoperative wound infections].

https://arctichealth.org/en/permalink/ahliterature215145
Source
Ugeskr Laeger. 1995 May 8;157(19):2717-9
Publication Type
Article
Date
May-8-1995
Author
H H Bentsen
L P Jensen
T U Håkansson
Author Affiliation
Hillerød Sygehus, organkirurgisk afdeling A.
Source
Ugeskr Laeger. 1995 May 8;157(19):2717-9
Date
May-8-1995
Language
Danish
Publication Type
Article
Keywords
Denmark - epidemiology
Humans
Medical Records Systems, Computerized - standards
Prospective Studies
Quality Assurance, Health Care
Questionnaires
Registries - standards
Retrospective Studies
Surgery Department, Hospital - standards - statistics & numerical data
Surgical Wound Infection - epidemiology
Abstract
At the Department of General Surgery, Hillerød Hospital, the quality of data from a continuous registration of post-operative wound infection was evaluated. Data registered over a six-month period were compared with data available in caserecords and data from a questionnaire sent to the patients. During the period 1.2-31.7.1990 924 operations were registered in 864 patients. Eight hundred and ninety-five patient records could be traced and 770 questionnaires were sent. The remaining 125 were dead or had unknown addresses. Six hundred eighty-seven questionnaires were returned. The data-registered overall infection rate was 3.0%. The actual infection rate was 8.9%. Fifty-eight percent of the infections noted in the records were registered. Approximately 40% of the infections were diagnosed and treated in general practice only. It is concluded that in order to compare infection rates between departments, it is necessary to ensure that equal definitions and equal quality of the data are used. Strict routines in the department and a close contact to the general practitioners are essential to achieve a satisfactory quality of data.
PubMed ID
7770971 View in PubMed
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The selection for post-mortem examination: a retrospective analysis of 74 deceased surgical cases.

https://arctichealth.org/en/permalink/ahliterature23862
Source
Qual Assur Health Care. 1993 Dec;5(4):345-9
Publication Type
Article
Date
Dec-1993
Author
I. Alafuzoff
B. Veress
Author Affiliation
Department of Pathology, Karolinska Institute, Huddinge University Hospital, Sweden.
Source
Qual Assur Health Care. 1993 Dec;5(4):345-9
Date
Dec-1993
Language
English
Publication Type
Article
Keywords
Aged
Autopsy - statistics & numerical data
Cause of Death
Diagnostic Errors
Female
Hospital Mortality
Hospitals, University - standards
Humans
Length of Stay - statistics & numerical data
Male
Medical Audit - methods
Middle Aged
Neoplasms - mortality - pathology - surgery
Postoperative Complications - mortality - pathology
Quality Assurance, Health Care - statistics & numerical data
Retrospective Studies
Surgery Department, Hospital - standards - statistics & numerical data
Sweden
Abstract
The factors which could influence the selection of cases for post-mortem examination were analysed during a 6-month period. The variables studied included the age and sex of the patients, the length of terminal hospitalization, the principal disease, the certainty of the clinical diagnostics and the extent of the clinical investigation. Both clinical and autopsy records were reviewed. Seventy-four patients died at the Department of Surgery during this period of whom 50 (68% autopsy rate) were autopsied. The autopsy rate was influenced by (a) the length of the terminal hospitalization, (b) the diagnosis of the principal disease and, to a certain degree, (c) the extent of the clinical investigation. Thus, patients who were hospitalized for a shorter period, had no clinically diagnosed malignant tumours and were not investigated with more sophisticated methods were more frequently autopsied. The discrepancy rate between principal clinical and post-mortem diagnoses was 28% and was not influenced by the use of modern investigative methods.
PubMed ID
8018894 View in PubMed
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12 records – page 1 of 2.