Patient-Centered Quality Indicators for Pulmonary Resection

Stephen D. Cassivi, Mark S. Allen, Gregg D. Vanderwaerdt, Lori L. Ewoldt, Mary E. Cordes, Dennis A Wigle, Francis C. Nichols, Peter C. Pairolero, Claude Deschamps

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Quality of care is increasingly scrutinized. However, no standard quality measures exist for surgical care of patients undergoing pulmonary resection. Methods: Our thoracic surgical team developed a set of patient-centered quality of care measures specific to patients undergoing pulmonary resection. Measures were chosen that demonstrated evidence-based preoperative assessment, adequate mediastinal staging, and interventions to prevent and expeditiously treat postoperative morbidity. Medical records of all patients undergoing pulmonary resection in 2005 were analyzed. Results: In all, 606 patients (men:women = 330:276) underwent 628 pulmonary resections. Median age was 65.8 years (range, 2 to 93). Operative mortality was 2.1%. Pulmonary function testing within 1 year before surgery was documented in 74.2%. Electrocardiogram within 90 days before surgery was documented in 81.6% of patients 50 years and older. Smoking history was documented in all patients, and smoking cessation consultation was offered to 85.7% of current smokers. Deep venous thrombosis prophylaxis was implemented in 99.7%. Mediastinal staging was documented in 94.0% of patients undergoing lung cancer resection (n = 333). Postoperatively, 92.4% of patients used incentive spirometry. Atrial fibrillation treatment occurred within 45 minutes of onset in 70.5%. Postoperative analog pain scores were above 6 in only 7.4% of assessments; treatment and reassessment occurred within 2 hours in 81.0%. Follow-up planning was documented at hospital discharge in 100%. No National Quality Forum "never events" occurred. Conclusions: Patient-centered and clinically relevant quality measures can be developed and evaluated in general thoracic surgery. This panel of quality indicators highlights and guide areas for potential improvement in the care of patients undergoing pulmonary resection.

Original languageEnglish (US)
Pages (from-to)927-932
Number of pages6
JournalAnnals of Thoracic Surgery
Volume86
Issue number3
DOIs
StatePublished - Sep 2008

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Lung
Quality of Health Care
Patient Care
Medical Errors
Patient-Centered Care
Spirometry
Smoking Cessation
Postoperative Pain
Ambulatory Surgical Procedures
Venous Thrombosis
Atrial Fibrillation
Thoracic Surgery
Medical Records
Motivation
Lung Neoplasms
Electrocardiography
Thorax
Referral and Consultation
Smoking
History

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Cassivi, S. D., Allen, M. S., Vanderwaerdt, G. D., Ewoldt, L. L., Cordes, M. E., Wigle, D. A., ... Deschamps, C. (2008). Patient-Centered Quality Indicators for Pulmonary Resection. Annals of Thoracic Surgery, 86(3), 927-932. https://doi.org/10.1016/j.athoracsur.2008.04.021

Patient-Centered Quality Indicators for Pulmonary Resection. / Cassivi, Stephen D.; Allen, Mark S.; Vanderwaerdt, Gregg D.; Ewoldt, Lori L.; Cordes, Mary E.; Wigle, Dennis A; Nichols, Francis C.; Pairolero, Peter C.; Deschamps, Claude.

In: Annals of Thoracic Surgery, Vol. 86, No. 3, 09.2008, p. 927-932.

Research output: Contribution to journalArticle

Cassivi, SD, Allen, MS, Vanderwaerdt, GD, Ewoldt, LL, Cordes, ME, Wigle, DA, Nichols, FC, Pairolero, PC & Deschamps, C 2008, 'Patient-Centered Quality Indicators for Pulmonary Resection', Annals of Thoracic Surgery, vol. 86, no. 3, pp. 927-932. https://doi.org/10.1016/j.athoracsur.2008.04.021
Cassivi, Stephen D. ; Allen, Mark S. ; Vanderwaerdt, Gregg D. ; Ewoldt, Lori L. ; Cordes, Mary E. ; Wigle, Dennis A ; Nichols, Francis C. ; Pairolero, Peter C. ; Deschamps, Claude. / Patient-Centered Quality Indicators for Pulmonary Resection. In: Annals of Thoracic Surgery. 2008 ; Vol. 86, No. 3. pp. 927-932.
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abstract = "Background: Quality of care is increasingly scrutinized. However, no standard quality measures exist for surgical care of patients undergoing pulmonary resection. Methods: Our thoracic surgical team developed a set of patient-centered quality of care measures specific to patients undergoing pulmonary resection. Measures were chosen that demonstrated evidence-based preoperative assessment, adequate mediastinal staging, and interventions to prevent and expeditiously treat postoperative morbidity. Medical records of all patients undergoing pulmonary resection in 2005 were analyzed. Results: In all, 606 patients (men:women = 330:276) underwent 628 pulmonary resections. Median age was 65.8 years (range, 2 to 93). Operative mortality was 2.1{\%}. Pulmonary function testing within 1 year before surgery was documented in 74.2{\%}. Electrocardiogram within 90 days before surgery was documented in 81.6{\%} of patients 50 years and older. Smoking history was documented in all patients, and smoking cessation consultation was offered to 85.7{\%} of current smokers. Deep venous thrombosis prophylaxis was implemented in 99.7{\%}. Mediastinal staging was documented in 94.0{\%} of patients undergoing lung cancer resection (n = 333). Postoperatively, 92.4{\%} of patients used incentive spirometry. Atrial fibrillation treatment occurred within 45 minutes of onset in 70.5{\%}. Postoperative analog pain scores were above 6 in only 7.4{\%} of assessments; treatment and reassessment occurred within 2 hours in 81.0{\%}. Follow-up planning was documented at hospital discharge in 100{\%}. No National Quality Forum {"}never events{"} occurred. Conclusions: Patient-centered and clinically relevant quality measures can be developed and evaluated in general thoracic surgery. This panel of quality indicators highlights and guide areas for potential improvement in the care of patients undergoing pulmonary resection.",
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AU - Cordes, Mary E.

AU - Wigle, Dennis A

AU - Nichols, Francis C.

AU - Pairolero, Peter C.

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N2 - Background: Quality of care is increasingly scrutinized. However, no standard quality measures exist for surgical care of patients undergoing pulmonary resection. Methods: Our thoracic surgical team developed a set of patient-centered quality of care measures specific to patients undergoing pulmonary resection. Measures were chosen that demonstrated evidence-based preoperative assessment, adequate mediastinal staging, and interventions to prevent and expeditiously treat postoperative morbidity. Medical records of all patients undergoing pulmonary resection in 2005 were analyzed. Results: In all, 606 patients (men:women = 330:276) underwent 628 pulmonary resections. Median age was 65.8 years (range, 2 to 93). Operative mortality was 2.1%. Pulmonary function testing within 1 year before surgery was documented in 74.2%. Electrocardiogram within 90 days before surgery was documented in 81.6% of patients 50 years and older. Smoking history was documented in all patients, and smoking cessation consultation was offered to 85.7% of current smokers. Deep venous thrombosis prophylaxis was implemented in 99.7%. Mediastinal staging was documented in 94.0% of patients undergoing lung cancer resection (n = 333). Postoperatively, 92.4% of patients used incentive spirometry. Atrial fibrillation treatment occurred within 45 minutes of onset in 70.5%. Postoperative analog pain scores were above 6 in only 7.4% of assessments; treatment and reassessment occurred within 2 hours in 81.0%. Follow-up planning was documented at hospital discharge in 100%. No National Quality Forum "never events" occurred. Conclusions: Patient-centered and clinically relevant quality measures can be developed and evaluated in general thoracic surgery. This panel of quality indicators highlights and guide areas for potential improvement in the care of patients undergoing pulmonary resection.

AB - Background: Quality of care is increasingly scrutinized. However, no standard quality measures exist for surgical care of patients undergoing pulmonary resection. Methods: Our thoracic surgical team developed a set of patient-centered quality of care measures specific to patients undergoing pulmonary resection. Measures were chosen that demonstrated evidence-based preoperative assessment, adequate mediastinal staging, and interventions to prevent and expeditiously treat postoperative morbidity. Medical records of all patients undergoing pulmonary resection in 2005 were analyzed. Results: In all, 606 patients (men:women = 330:276) underwent 628 pulmonary resections. Median age was 65.8 years (range, 2 to 93). Operative mortality was 2.1%. Pulmonary function testing within 1 year before surgery was documented in 74.2%. Electrocardiogram within 90 days before surgery was documented in 81.6% of patients 50 years and older. Smoking history was documented in all patients, and smoking cessation consultation was offered to 85.7% of current smokers. Deep venous thrombosis prophylaxis was implemented in 99.7%. Mediastinal staging was documented in 94.0% of patients undergoing lung cancer resection (n = 333). Postoperatively, 92.4% of patients used incentive spirometry. Atrial fibrillation treatment occurred within 45 minutes of onset in 70.5%. Postoperative analog pain scores were above 6 in only 7.4% of assessments; treatment and reassessment occurred within 2 hours in 81.0%. Follow-up planning was documented at hospital discharge in 100%. No National Quality Forum "never events" occurred. Conclusions: Patient-centered and clinically relevant quality measures can be developed and evaluated in general thoracic surgery. This panel of quality indicators highlights and guide areas for potential improvement in the care of patients undergoing pulmonary resection.

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