Abstract 113: Technical Performance Scores as a quality assessment tool in Congenital Heart Surgery; preliminary analysis of validation data

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Meena Nathan ◽  
John Karamichalis ◽  
Steven Colan ◽  
Hua Liu ◽  
John E Mayer ◽  
...  
Keyword(s):  
Adverse Events ◽  
Quality Assessment ◽  
Scoring System ◽  
Heart Surgery ◽  
Assessment Tool ◽  
Congenital Heart Surgery ◽  
Quality Assessment Tool ◽  
Validation Data ◽  
Technical Performance ◽  
Class 1

BACKGROUND : In previous work from our institution, individual practitioner technical performance of surgical procedures has been shown to be an important contributor to outcome and resource utilization in selected congenital cardiac operations. We have developed a Technical Scoring System for evaluation of majority of congenital cardiac procedures and wish to validate its efficacy as a self assessment tool for quality improvement. METHODS : All patients who were discharged between Jan 1 2011 and Dec 31, 2011 were included in this study. Based on discharge echocardiograms, a technical performance score was assigned using previously designed criteria. Case complexity was determined by RACHS-I category, postoperative adverse events and mortality were prospectively monitored. Outcomes were analyzed by non parametric methods. RESULTS : There were a total of 842 discharges encompassing all ages from neonates to adults. 560 (67%) were in RACHS-1 categories 1 to 3 (low risk) and 130 (15%) were in RACHS-1 categories 4 to 6 (high risk) and 152 (18%) could not be categorized. Technical performance scores were as follows: 436 (52%) class 1-optimal, 242(29%) class 2-adequate, 96 (115) class 3-inadequate, and 68(8%) could not classified. Occurrence of major adverse events, mortality and length of stay were all significantly higher in class 3. CONCLUSION : Preliminary data validates the usefulness of the technical scoring system as a quality assessment tool.

Abstract 220: Technical Performance Scores Predict Outcomes Following Congenital Heart Surgery: Multicenter Validation

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Meena Nathan ◽  
Hua Liu ◽  
Steven D Colan ◽  
Lazaros Kochilas ◽  
Geetha Raghuveer ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Stay ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Assessment Tool ◽  
Multivariable Analysis ◽  
Congenital Heart Surgery ◽  
Hospital Length Of Stay ◽  
Atrioventricular Canal ◽  
Technical Performance

BACKGROUND: In previous work from a single center, Technical Performance Score (TPS), a tool that assesses technical adequacy of repair, has been shown to be strongly associated with outcomes in congenital cardiac surgery. We sought to validate the efficacy of TPS in a multicenter environment. METHODS: All patients (1 day to 62 years) who were discharged from January 1 to December 31, 2011; and who underwent 9 congenital cardiac procedures (Arterial switch operation [84], Bidirectional Glenn [75], Atrioventricular canal repair [135], Fontan [97], Arch repair on pump [58], Stage I Procedure [85], Pulmonary valve replacement [116], Tetralogy of Fallot repair [112], and Ventricular septal defect repair [163]); from 5 centers were included. Based on echocardiograms (echo) prior to discharge or death, and unplanned reinterventions at surgical site; TPS was assigned using previously established criteria. Case complexity was determined by RACHS-1 category. Outcomes included (a) major postoperative adverse events (AE) excluding unplanned reinterventions, (b) length of ventilation, and (c) postoperative hospital stay. Adjusted analysis used logistic/linear regression to determine odds ratio (OR) and regression coefficient (b) for each outcome. RESULTS: There were 925 hospital discharges: 418 (45%) were RACHS-1 category 2, 295 (32%) category 3, 85 (9%) category 4, 86 (9%) category 6 and the cohort included 41 (4%) adults. TPS were as follows: 491 (53%) class 1-optimal, 263 (28%) class 2-adequate, 131 (14%) class 3-inadequate and 40 (4%) had no TPS assigned because of a lack of or incomplete echos (NA). There were 26 (2.8%) deaths (81% of deaths were in class 3) and 105 (11%) adverse events. Occurrence of major adverse events, ventilation time and hospital length of stay were all significantly higher in class 3 (Figure). On multivariable analysis adjusting for age, RACHS-1, prematurity, and presence of non-cardiac anomalies; Class 3 TPS was associated with a higher odds of AE (OR 7.4, CI 4.1-13.2, p<0.001), longer ventilation (b 1.9, CI 1.6-2.2, p<0.001), and hospital stay (b 1.6, CI 1.4 to 1.8, p<0.001). CONCLUSION: TPS predicts outcomes after congenital heart surgery in a multicenter cohort, and can serve as quality assessment tool. Outcomes may be favorably influenced by focusing on technical excellence.

scholarly journals rnaQUAST: a quality assessment tool forde novotranscriptome assemblies: Table 1.

2016 ◽  
Vol 32 (14) ◽  
pp. 2210-2212 ◽  
Author(s):  
Elena Bushmanova ◽  
Dmitry Antipov ◽  
Alla Lapidus ◽  
Vladimir Suvorov ◽  
Andrey D. Prjibelski
Keyword(s):  
Quality Assessment ◽  
Assessment Tool ◽  
Quality Assessment Tool

QUANTIS: Data quality assessment tool by clustering analysis

2019 ◽  
Vol 51 (11) ◽  
pp. 872-885
Author(s):  
Steffen H. Symoens ◽  
Syam Ukkandath Aravindakshan ◽  
Florence H. Vermeire ◽  
Kevin De Ras ◽  
Marko R. Djokic ◽  
...  
Keyword(s):  
Data Quality ◽  
Quality Assessment ◽  
Clustering Analysis ◽  
Assessment Tool ◽  
Quality Assessment Tool ◽  
Data Quality Assessment

scholarly journals Impact of integrating pharmacists into primary care teams on health systems indicators: a systematic review

2019 ◽  
Vol 69 (687) ◽  
pp. e665-e674 ◽  
Author(s):  
Benedict Hayhoe ◽  
Jose Acuyo Cespedes ◽  
Kimberley Foley ◽  
Azeem Majeed ◽  
Judith Ruzangi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health System ◽  
Quality Assessment ◽  
Observational Studies ◽  
Assessment Tool ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Quality Assessment Tool

BackgroundEvidence suggests that pharmacists integrated into primary care can improve patient outcomes and satisfaction, but their impact on healthcare systems is unclear.AimTo identify the key impacts of pharmacists’ integration into primary care on health system indicators, such as healthcare utilisation and costs.Design and settingA systematic review of literature.MethodEmbase, MEDLINE, Scopus, the Health Management Information Consortium, CINAHL, and the Cochrane Central Register of Controlled Trials databases were examined, along with reference lists of relevant studies. Randomised controlled trials (RCTs) and observational studies published up until June 2018, which considered health system outcomes of the integration of pharmacists into primary care, were included. The Cochrane risk of bias quality assessment tool was used to assess risk of bias for RCTs; the National Institute of Health National Heart, Lung, and Blood Institute quality assessment tool was used for observational studies. Data were extracted from published reports and findings synthesised.ResultsSearches identified 3058 studies, of which 28 met the inclusion criteria. Most included studies were of fair quality. Pharmacists in primary care resulted in reduced use of GP appointments and reduced emergency department (ED) attendance, but increased overall primary care use. There was no impact on hospitalisations, but some evidence of savings in overall health system and medication costs.ConclusionIntegrating pharmacists into primary care may reduce GP workload and ED attendance. However, further higher quality studies are needed, including research to clarify the cost-effectiveness of the intervention and the long-term impact on health system outcomes.

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