An institutional analysis of unplanned return to the operating room to identify areas for quality improvement

Yihan Lin, Robert A. Meguid, Patrick W. Hosokawa, William G. Henderson, Karl E. Hammermeister, Richard D. Schulick, Ryan C. Shelstad, Trevor T. Wild, Robert C. McIntyre

Research output: Contribution to journalArticle

Abstract

Background: Unplanned return to the operating room (uROR) has been suggested as a hospital quality indicator. The purpose of this study was to determine reasons for uROR to identify opportunities for patient care improvement. Methods: uROR reported by our institution's American College of Surgeons National Surgical Quality Improvement Program underwent secondary review. Results: The uROR rate reported by clinical reviewers was 4.3%. Secondary review re-categorized 64.7% as "true uROR" with the most common reasons for uROR being infection (30.9%) and bleeding (23.6%). Remaining cases were categorized as "false uROR" with the most common reasons being inadequate documentation (60.0%) and not directly related to index procedure (16.7%). Conclusions: Strict adherence to NSQIP definitions results in misidentification of true uROR. This raises concerns for using NSQIP-identified uROR as a hospital quality metric. Improved processes of care to prevent infection and hemorrhage at our institution could reduce the rate of true uROR.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jul 30 2016
Externally publishedYes

Fingerprint

Operating Rooms
Quality Improvement
Hemorrhage
Infection
Documentation
Patient Care

Keywords

  • ACS
  • NSQIP
  • Quality improvement
  • Reoperation
  • Unplanned return to the operating room

ASJC Scopus subject areas

  • Surgery

Cite this

Lin, Y., Meguid, R. A., Hosokawa, P. W., Henderson, W. G., Hammermeister, K. E., Schulick, R. D., ... McIntyre, R. C. (Accepted/In press). An institutional analysis of unplanned return to the operating room to identify areas for quality improvement. American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2016.10.021

An institutional analysis of unplanned return to the operating room to identify areas for quality improvement. / Lin, Yihan; Meguid, Robert A.; Hosokawa, Patrick W.; Henderson, William G.; Hammermeister, Karl E.; Schulick, Richard D.; Shelstad, Ryan C.; Wild, Trevor T.; McIntyre, Robert C.

In: American Journal of Surgery, 30.07.2016.

Research output: Contribution to journalArticle

Lin, Y, Meguid, RA, Hosokawa, PW, Henderson, WG, Hammermeister, KE, Schulick, RD, Shelstad, RC, Wild, TT & McIntyre, RC 2016, 'An institutional analysis of unplanned return to the operating room to identify areas for quality improvement', American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2016.10.021
Lin, Yihan ; Meguid, Robert A. ; Hosokawa, Patrick W. ; Henderson, William G. ; Hammermeister, Karl E. ; Schulick, Richard D. ; Shelstad, Ryan C. ; Wild, Trevor T. ; McIntyre, Robert C. / An institutional analysis of unplanned return to the operating room to identify areas for quality improvement. In: American Journal of Surgery. 2016.
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