 |
|
Measuring and Managing Quality of SurgeryStatistical vs Incidental Approaches
Hunter H. McGuire, Jr, MD;
J. Shelton Horsley, III, MD;
David R. Salter, MD;
Michael Sobel, MD
Arch Surg. 1992;127(6):733-738.
Abstract
• New rules for quality assurance provoked a comparison of effects of two approaches used concurrently for 14 years. In an incidental approach, a multidisciplinary conference reviewed all postoperative complications as they occurred and attributed each to one of six causes. Remedies were instituted and data were filed. In a statistical approach, death and complication rates were computed annually and compared with previous years' rates and with rates reported to Congress as national norms. Statistics suggested acceptable quality in each specialty but calculations were tedious and differences achieved significance too rarely or too slowly to identify problems, protect patients, and improve care. The incidental approach was popular and produced immediate improvements in patient care. Conferees attributed one half of complications to errors. Frequent acknowledgment of susceptibility to error may contribute to the safety and quality shown by our statistics.
(Arch Surg. 1992;127:733-738)
Author Affiliations
From the Department of Surgery, Virginia Commonwealth University, Richmond.
Footnotes
Accepted for publication December 21, 1991.
Reprint requests to the Veterans Affairs Medical Center, Richmond, VA 23249 (Dr McGuire).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Effects of study methodology on adverse outcome occurrence and mortality
Marang-van de Mheen et al.
Int J Qual Health Care 2007;19:399-406.
ABSTRACT
| FULL TEXT
Video Technology to Advance Safety in the Operating Room and Perioperative Environment
Yan Xiao et al.
SURG INNOV 2007;14:52-61.
ABSTRACT
Reorganizing the System of Care Surrounding Laparoscopic Surgery: A Cost-Effectiveness Analysis Using Discrete-Event Simulation
Stahl et al.
Med Decis Making 2004;24:461-471.
ABSTRACT
Addition of "Near-Miss" Cases Enhances a Quality Improvement Conference
McCafferty and Polk
Arch Surg 2004;139:216-217.
ABSTRACT
| FULL TEXT
A preliminary taxonomy of medical errors in family practice
Dovey et al.
BMJQS 2002;11:233-238.
ABSTRACT
| FULL TEXT
Complications in Surgical Patients
Healey et al.
Arch Surg 2002;137:611-618.
ABSTRACT
| FULL TEXT
Surgical Palliation at a Cancer Center: Incidence and Outcomes
Krouse et al.
Arch Surg 2001;136:773-778.
ABSTRACT
| FULL TEXT
The "New VA": A National Laboratory for Health Care Quality Management
Kizer
American Journal of Medical Quality 1999;14:3-20.
ABSTRACT
The Quality of Surgery: Statistical vs Incidental Approaches
SCHNEIDER
Arch Surg 1993;128:109-109.
ABSTRACT
|
