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. 2022 Jun 14:10:20503121221103221.
doi: 10.1177/20503121221103221. eCollection 2022.

Examining the adaptability and validity of interRAI acute care quality indicators in a surgical context

Timothy Wood  1 , Mark Chatfield  2 , Leonard Gray  2 , Nancye Peel  2 , Shannon Freeman  1 , Melinda Martin-Khan  2
Affiliations

Examining the adaptability and validity of interRAI acute care quality indicators in a surgical context

Timothy Wood et al. SAGE Open Med. .

Abstract

Background: Currently, the use of quality indicators in the surgical setting may be challenged by diverse patient needs, clinical complexity, and health trajectories. Therefore, the objective of this study was to examine the adaptability of existing quality indicators to a surgical context and propose new time points.

Methods: A multi-method approach included an environmental scan of the literature, consultation with multinational experts, and analysis of surgical patient data. Quality indicators from the nurse-administered interRAI Acute Care instrument were examined within a surgical context using secondary data from a hospital in Brisbane, Australia (N = 1006 surgical cases).

Results: A lack of relevancy of existing time points can preclude meaningful quality indicator measurement. Definitions of some quality indicators were adapted to ensure relevancy for the surgical population. As well, a surgical baseline (measured preoperative and post-injury) and a 48-h postoperative time point were added to the existing measurement timeline.

Conclusion: Distinct measurement timelines were created for elective and non-elective surgical patients. The use of surgery-specific time points that can be embedded into an existing Acute Care measurement framework supports consistent quality indicator reporting. This study represents the first steps towards standardized quality reporting for health information systems across different care settings.

Keywords: Quality indicators; acute care; critical care; quality of care; surgery.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Potential conflict of interest exists for co-authors N.P., L.G., and M.M.K., who are interRAI members; otherwise, the authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Comprehensive electronic geriatric assessment dataset–pain intensity by time point.
Figure 2.
Figure 2.
Independent Walking ADL by time point.
Figure 3.
Figure 3.
Comprehensive electronic geriatric assessment dataset – primary mode of locomotion by time point.
See this image and copyright information in PMC

References

    1. Kohn LT, Corrigan JM, Donaldson M, et al.. To Err is human: building a safer health system. Institute of Medicine (IOM) Report. Washington, DC: National Academies Press, 2000. - PubMed
    1. Etzioni DA, Liu JH, Maggard MA, et al.. The aging population and its impact on the surgery workforce. Ann Surg 2003; 238(2): 170–177. - PMC - PubMed
    1. Hamel MB, Henderson WG, Khuri SF, et al.. Surgical outcomes for patients aged 80 and older: morbidity and mortality from major noncardiac surgery. J Am Geriatr Soc 2005; 53(3): 424–429. - PubMed
    1. Brennan TA, Leape LL, Laird NM, et al.. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard medical practice study I. New Engl J Med 1991; 324(6): 370–376. - PubMed
    1. Griffin FA, Classen DC. Detection of adverse events in surgical patients using the trigger tool approach. Qual Saf Health Care 2008; 17(4): 253–258. - PubMed