National Surgical Quality Improvement Program integration with Morbidity and Mortality conference is essential to success in the march to zero

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• 作者：Lori A. Gurien ; M.D. ; M.P.H. ; ^{lgurien@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Jin H. Ra ; M.D. ; Andrew J. Kerwin ; M.D. ; Michael S. Nussbaum ; M.D. ; Marie Crandall ; M.D. ; M.P.H. ; Jhun deVilla ; M.D. ; Joseph J. Tepas 3rd ; M.D.
• 关键词：Adverse events ; Morbidity and mortality ; NSQIP ; Outcomes ; Quality improvement ; Surgical procedures
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：212
• 期：4
• 页码：623-628
• 全文大小：491 K

文摘

Morbidity and Mortality conference (M&M) and the National Surgical Quality Improvement Program (NSQIP) are systems to improve surgical care. We evaluated the commonality of adverse events (AEs) and the change in AE rates after integration.

Methods

A single institution's NSQIP and M&M registries were analyzed to determine commonality of AE reported. Causal determinant groups were then created to categorize and standardize AE. Incidence of AE and patient commonality identified by these systems was evaluated over 2 years.

Results

The 68 common patients identified in 2012 represented 27% of NSQIP and 43% of M&M patients. Common AE reported by M&M and NSQIP decreased from 16.9% (2013) to 9.6% (2014). Causality code analysis demonstrated significant differences in proportion of issues addressed within each (P < .0001).

Conclusions

Despite standardized coding, M&M focus differed from NSQIP. Low commonality affirms NSQIP as a critical adjunct to voluntary reporting. Combining both may help eliminate preventable AEs.