Sequential analysis of uncommon adverse outcomes

The Journal of Hospital Infection
A MortonD Looke

Abstract

Sequential analysis of uncommon adverse outcomes (AEs) such as surgical site infections (SSIs) is desirable. Short postoperative lengths of stay (LOS) result in many SSIs occurring after discharge and they are often superficial. Deep and organ space (complex) SSIs occur less frequently but are detected more reliably and are suitable for monitoring wound care. Those occurring post-discharge usually require readmissison and can be counted accurately. Sequential analysis of meticillin-resistant Staphylococcus aureus bacteraemia is also needed. The key to prevention is to implement systems based on evidence, e.g. using 'bundles' and checklists. Regular mortality and morbidity audit meetings are required and these may need to be followed by independent audits. Sequential statistical analysis is desirable for data presentation, to detect changes, and to discourage tampering with processes when occasional AEs occur in a reliable system. Tabulations and cumulative observed minus expected (O-E) charts and funnel plots are valuable, supplemented in the presence of apparent 'runs' of AEs by cumulative sum analysis. Used prospectively, they may enable staff to visualise and detect patterns or shifts in rates and counts that might not other...Continue Reading

References

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Apr 12, 2007·Quality Management in Health Care·Marilyn K HartStephen Schmaltz
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Nov 13, 2007·Ophthalmology·Jonathon Q NgJames B Semmens
Dec 1, 2007·Quality Management in Health Care·Farrokh Alemi
Aug 12, 2008·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Anthony P MortonMichael Whitby
Sep 24, 2008·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Deverick J AndersonKeith S Kaye
Jan 24, 2009·The Annals of Thoracic Surgery·Gary L GrunkemeierYingXing Wu

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Citations

Nov 3, 2012·Australian Health Review : a Publication of the Australian Hospital Association·Anna BarkerAnthony Morton

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