The Impact of Documentation Training on Performance Reporting
The Impact of Documentation Training on Performance Reporting
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DOI：
10.7759/cureus.283
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发表时间：
2015-07-01
影响因子：
1.2
通讯作者：
Ramanujam, Paravasthu
中科院分区：
文献类型：
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作者：
Loftus, Terrence;Najafian, Hadi;Ramanujam, Paravasthu
随着医生对临床表现的公开报告的到来，对准确文件的需求是必不可少的。这项研究测试了这样一种假设，即为一组结直肠外科医生提供五个关键文档提示的简短教程可以显著改善他们报告的临床表现。在引入一个简短的教程之前和之后，收集了总共626名连续住院患者的数据，重点是向一组结直肠外科医生提供的五个关键文件提示。对两个时间段的质量指标进行了比较。并发症(p=0.001)、发病率(p=0.046)、肠梗阻(p=0.027)和消化系统并发症(p=0.027)均有显著改善。在死亡率(p=0.569)或再入院(p=0.920)方面没有差异。一个简短的教程集中在五个关键的文件提示与改善报告的结直肠外科医生的临床表现有关。
With the advent of public reporting of clinical performance for physicians, the need for accurate documentation is essential. This study tested the hypothesis that a short tutorial on five key documentation tips for a group of colorectal surgeons could significantly improve their reported clinical performance. Data was collected on a total of 626 consecutive inpatients before and after the introduction of a short tutorial focusing on five key documentation tips to a group of colorectal surgeons. Quality metrics were compared between the two time periods. Significant improvements were observed for complications (p = 0.001), morbidity (p = 0.046), ileus (p = 0.027), and digestive system complications (p < 0.01). There was no difference in mortality (p = 0.569) or readmissions (p = 0.920). A short tutorial focusing on five key documentation tips is associated with improvement in the reported clinical performance of colorectal surgeons.