<h3>Importance</h3> Financial penalties for readmission have been expanded beyond medical conditions to include surgical procedures. Hospitals are working reduce readmissions; however, little is known about the reasons readmission. <h3>Objective</h3> To characterize reasons, timing, and factors associated with unplanned postoperative readmissions. <h3>Design, Setting, Participants</h3> Patients undergoing surgery at one of 346 continuously enrolled US hospitals participating in American...

Postoperative venous thromboembolism (VTE) rates are widely reported quality metrics soon to be used in pay-for-performance programs. Surveillance bias occurs when some clinicians use imaging studies detect VTE more frequently than other clinicians. Because they look more, find events, paradoxically worsening their hospital's measure performance. A surveillance may influence measurement if (1) greater hospital prophylaxis adherence fails result lower measured rates, (2) hospitals with...

IMPORTANCE Surgical site infection (SSI) has emerged as the leading publicly reported surgical outcome and is tied to payment determinations.Many hospitals monitor SSIs using American College of Surgeons National Quality Improvement Program (ACS NSQIP), in addition mandatory participation (for most states) Centers for Disease Control Prevention's Healthcare Safety Network (NHSN), which resulted duplication effort incongruent data.OBJECTIVE To identify discrepancies implementation NHSN ACS...

Objective: The study aimed to assess the quality of preschool piano education in Weifang, examining its goals, content, and learning outcomes. It also explored ways enhance teaching efficacy through improved curricula, resources, methodologies. Theoretical Framework: theoretical framework for this is grounded educational developmental theories, emphasizing role early childhood music fostering cognitive, emotional, social development. draws on principles constructivism, which highlight active...

Background: Symptomatic pre-discharge venous thromboembolism (VTE) rates after total or partial hip knee arthroplasty have been proposed as patient safety indicators. However, assessing only VTE may be suboptimal for quality measurement the duration of stay is relatively short and risk extends beyond inpatient setting. Methods: Patients who underwent were identified in 2008 through 2010 American College Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Outcomes...

Postoperative venous thromboembolism (VTE) is important clinically, and VTE quality metrics are used in public reporting pay-for-performance programs. However, current outcome measures not valid due to surveillance bias, the Surgical Care Improvement Project (SCIP-VTE-2) process measure only requires prophylaxis within 24 hours of surgery.We sought (1) develop a novel that early ambulation, mechanical prophylaxis, chemoprophylaxis throughout hospitalization, (2) compare hospital performance...

The objective was to assess the presence and extent of venous thromboembolic (VTE) surveillance bias using high-quality clinical data.Hospital VTE rates are publicly reported used in pay-for-performance programs. Prior work suggested bias: hospitals that look more for with imaging studies find VTE, thereby incorrectly seem have worse performance. However, these results been questioned as risk adjustment measurement relied on administrative data.Data (2009-2010) from 208 were available...

Background Recent research suggests that hospital rates of postoperative venous thromboembolism (VTE) are subject to surveillance bias: the more hospitals ‘look for’ VTE, VTE they find. However, little is known about what drives variation in imaging rates. We conducted an observational study examine and market characteristics were associated with hospital-level imaging, focusing on particularly high Methods For Medicare beneficiaries undergoing 11 major operations (2009–2010) at 2820...

In Brief The Agency for Healthcare Research and Quality Patient Safety Indicator 12 Postoperative Venous Thromboembolism (VTE) does not accurately reflect true hospital quality because (1) current measure specifications preclude excluding nonclinically significant VTE from the numerator, (2) all patients in denominator are at risk of diagnosis.

Endovascular repair of abdominal aortic aneurysms (EVAR) has largely supplanted open surgery over the past 2 decades. Faced with an aging population, outcomes EVAR among various age groups were examined.Retrospective review elective cases was performed at a single institution from 1998 to 2009. Patients separated into 4 for easy comparison. Perioperative data analyzed using Fisher's exact test.Demographics similar except sex, BMI, and smoking status. The 30-day morbidity mortality not...

BACKGROUND Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process‐of‐care measures ensure appropriate VTE prophylaxis assess healthcare‐associated prevention efforts. OBJECTIVE To evaluate impact of an institution‐wide project aimed at improving hospital performance measures. DESIGN A retrospective observational study. SETTING NMH,...

Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular repair (TEVAR) has emerged as suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management the rupture. We hypothesize that early decompression TEVAR for ruptured aneurysms decreases rate postoperative complications. Methods Single-center, retrospective eight-year review...

Objectives: Readmission is increasingly used as a hospital quality indicator. Our objectives were to (1) report readmission rates after pulmonary resection, (2) identify potential risk factors for readmission, and (3) describe the causes of in this patient population. Methods: Patients who underwent resection identified from 2011 American College Surgeons National Surgical Quality Improvement Program data. Four groups examined: all resections, open lobectomy (OL), VATS (VL), pneumonectomy....

Introduction: Carotid webs are shelf-like projections of the carotid bulb lumen associated with ipsilateral ischemic stroke in young patients. Given its rarity, a limited number studies have evaluated optimal management symptomatic to prevent further stroke. Case Report: A 40-year-old Caucasian man presented sudden onset left-sided facial droop, hemiparesis, and dysarthria. Computed tomography angiography revealed occlusion distal M1 proximal M2 segments right middle cerebral artery small...