BMJ quality & safety
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BMJ quality & safety · Sep 2013
The Housestaff Incentive Program: improving the timeliness and quality of discharge summaries by engaging residents in quality improvement.
Quality improvement has become increasingly important in the practice of medicine; however, engaging residents in meaningful projects within the demanding training environment remains challenging. ⋯ Our discharge summary improvement project provides an instructive example of how residents can lead clinically meaningful quality improvement projects.
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BMJ quality & safety · Sep 2013
Anastomotic leakage as an outcome measure for quality of colorectal cancer surgery.
When comparing mortality rates between hospitals to explore hospital performance, there is an important role for adjustment for differences in case-mix. Identifying outcome measures that are less influenced by differences in case-mix may be valuable. The main goal of this study was to explore whether hospital differences in anastomotic leakage (AL) and postoperative mortality are due to differences in case-mix or to differences in treatment factors. ⋯ Hospital variation in AL is relatively independent of differences in case-mix. In contrast to 'postoperative mortality' the observed AL rates of hospitals evaluated in our study were only slightly affected after adjustment for case-mix factors. Therefore, AL rates may be suitable as an outcome indicator for measurement of surgical quality of care.