Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals

• DOI: 10.2147/clep.s157162
• Publication Date: 2018-04-17T20:26:41Z
• Authors: Thomas Bøjer Rasm...; Sinna Pilgaard Ul...; Mette Nørgaard
• Keywords: CUSUM; Interquartile range; Danish

Monitoring hospital outcomes and clinical processes as a measure of performance is an integral part modern health care. The risk-adjusted cumulative sum (CUSUM) chart frequently used sequential analysis technique that can be implemented to monitor wide range different types outcomes.The aim this study was describe how CUSUM charts based on population-based nationwide medical registers were 30-day mortality in Danish hospitals give example alarms increased from the guide further in-depth analyses.We routinely collected administrative data National Patient Registry Civil Registration System create charts. We monitored after admission with one 77 selected diagnoses 24 units Denmark 2015. set detect 50% increase mortality, control limits determined by simulations.Among 1,085,576 admissions, 441,352 admissions had their primary diagnosis included yielded total eight mortality. median hospitals' estimated average time 50 days (interquartile interval, 43;54). In alarm, descriptive analyses indicated problems following hip fracture surgery chronic obstructive pulmonary disease.The presented implementation significant increases within 2 months, average, most hospitals. Together analyses, it possible use alarm identify potential problems.