Attribution 2.0: whose complication is it?

Greg Hambright, Theresa Jackson, Vaidehi Agrawal, Antonio Arazosa, Benjamin Newman, Michael S. Truitt

Research output: Contribution to journalArticle

Abstract

Background Payment models aimed at improving quality and curbing costs are being deployed, and hospitals are evaluating complications more closely. To decrease complications, hospitals must first “attribute” them to a responsible party. Our study uses a rigorous approach to attribution in the trauma population. Methods Twelve months of complications were reviewed by a multidisciplinary panel. Physicians, patients, nursing, and the hospital were all incorporated into the model. A point system was developed for each complication. Fractional points were given when multiple parties were involved. Results One hundred twenty-five complications were analyzed. Complications were attributed as follows: 30% neurosurgery, 22% trauma surgery (100% using the traditional method), 17% orthopedic surgery, 14% nursing, 9.6% plastics, 3.8% hospital, 1.6% patient, 1.4% urology, and.6% vascular. Conclusions Up to 78% of complications were incorrectly ascribed using the traditional method. Almost 20% of complications resulted from factors outside the physician's control. Before complications can be reduced, their most proximate cause must be identified. Surgeons should own these data and lead the effort to improve quality and decrease complications.

Original languageEnglish (US)
Pages (from-to)1090-1095
Number of pages6
JournalAmerican Journal of Surgery
Volume212
Issue number6
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Fingerprint

Nursing
Physicians
Wounds and Injuries
Neurosurgery
Urology
Plastics
Orthopedics
Blood Vessels
Costs and Cost Analysis
Population
Surgeons

Keywords

  • Attribution
  • Complications
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Hambright, G., Jackson, T., Agrawal, V., Arazosa, A., Newman, B., & Truitt, M. S. (2016). Attribution 2.0: whose complication is it? American Journal of Surgery, 212(6), 1090-1095. https://doi.org/10.1016/j.amjsurg.2016.09.004

Attribution 2.0 : whose complication is it? / Hambright, Greg; Jackson, Theresa; Agrawal, Vaidehi; Arazosa, Antonio; Newman, Benjamin; Truitt, Michael S.

In: American Journal of Surgery, Vol. 212, No. 6, 01.12.2016, p. 1090-1095.

Research output: Contribution to journalArticle

Hambright, G, Jackson, T, Agrawal, V, Arazosa, A, Newman, B & Truitt, MS 2016, 'Attribution 2.0: whose complication is it?', American Journal of Surgery, vol. 212, no. 6, pp. 1090-1095. https://doi.org/10.1016/j.amjsurg.2016.09.004
Hambright G, Jackson T, Agrawal V, Arazosa A, Newman B, Truitt MS. Attribution 2.0: whose complication is it? American Journal of Surgery. 2016 Dec 1;212(6):1090-1095. https://doi.org/10.1016/j.amjsurg.2016.09.004
Hambright, Greg ; Jackson, Theresa ; Agrawal, Vaidehi ; Arazosa, Antonio ; Newman, Benjamin ; Truitt, Michael S. / Attribution 2.0 : whose complication is it?. In: American Journal of Surgery. 2016 ; Vol. 212, No. 6. pp. 1090-1095.
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