Postoperative respiratory failure: An update on the validity of the Agency for Healthcare Research and Quality Patient Safety Indicator 11 in an era of clinical documentation improvement programs.

Postoperative respiratory failure: An update on the validity of the Agency for Healthcare Research and Quality Patient Safety Indicator 11 in an era of clinical documentation improvement programs.
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DOI:
10.1016/j.amjsurg.2019.11.019
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发表时间:
2020-07
影响因子:
3
通讯作者:
Romano, Patrick S.
Romano, Patrick S.
中科院分区:
医学3区
文献类型:
--
作者:
Stocking, Jacqueline C.;Utter, Garth H.;Drake, Christiana;Aldrich, J. Matthew;Ong, Michael K.;Amin, Alpesh;Marmor, Rebecca A.;Godat, Laura;Cannesson, Maxime;Gropper, Michael A.;Romano, Patrick S.

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管理数据可用于识别术后呼吸衰竭(PRF)病例。我们的目的是确定最近对医疗保健研究和质量机构患者安全指标11(PSI 11)的变更以及临床文件改进计划的采用是否提高了PSI 11的有效性。我们还分析了PSI 11被错误触发的原因。使用2012年10月1日至2015年9月30日期间五个学术医疗中心的健康记录数据对所有符合条件的出院者进行横断面研究。在437个标记的记录中,434个(99.3%)被准确编码,414个(94.7%)代表真实的临床PRF。所有假阳性记录均不涉及入院时存在的呼吸衰竭。大多数(78.3%)假阳性记录需要气道保护,但没有呼吸衰竭。PSI 11的有效性随着最近代码标准的变更和临床文件改进计划的采用而得到改善。
Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity of PSI 11. We also analyzed reasons why PSI 11 was falsely triggered. Cross-sectional study of all eligible discharges using health record data from five academic medical centers between October 1, 2012 and September 30, 2015. Of 437 flagged records, 434 (99.3%) were accurately coded and 414 (94.7%) represented true clinical PRF. None of the false positive records involved respiratory failure present on admission. Most (78.3%) false positive records required airway protection but did not have respiratory failure. The validity of PSI 11 has improved with recent changes to the code criterion and adoption of clinical documentation improvement programs.
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