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Surgical quality indicators in low-resource settings: A new evidence-based tool

Citron, I. (författare)
Saluja, S. (författare)
Amundson, J. (författare)
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Ferreira, R. V. (författare)
Ljungman, David (författare)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
Alonso, N. (författare)
Moutinho, V. (författare)
Meara, J. G. (författare)
Steer, M. (författare)
Mpbell Wb, Annals Of The Royal College Of Surgeons Of England V. P. (författare)
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2018
2018
Engelska.
Ingår i: Surgery. - 0039-6060. ; 164:5, s. 946-952
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: Worldwide efforts to improve access to surgical care must be accompanied by improvements in the quality of surgical care; however, these efforts are contingent on the ability to measure quality. This report describes a novel, evidence-based tool to measure quality of surgical care in low-resource settings. Methods: We defined a widely applicable, multidimensional conceptual framework for quality. The suitability of currently available quality metrics to low-resource settings was evaluated. Then we developed new indicators with sufficient supportive evidence to complete the framework. The complete set of metrics was condensed into four collection sources and tools. Results: The following 15 final evidence-based indicators were defined: (1) Safe structure: morbidity and mortality conference; (2) safe process: use of the safe surgery checklist; (3) (4) safe outcomes: perioperative mortality rate and proportion of cases with complications graded >2 on the Clavien-Dindo scale; (5) effective structure: provider density; (6) effective process: procedure rate; (7) effective outcome: rate of caesarean sections; (8) patient-centered process: use of informed consent; (9) patient-centered outcome: patient hospital satisfaction questionnaire; (10) timely structure: travel time to hospital; (11) timely process: time from emergency department presentation to non-elective abdominal surgery; (12) timely outcome: patient follow-up plan; (13) efficient process: daily operating room usage; (14) equitable outcome: comparative income of patients compared with population; and (15) proportion of patients facing catastrophic expenditure because of surgical care. Conclusion: This tool provides an evidence-based conceptual tool to assess the quality of surgical care in diverse low-resource settings.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

medical-care
health-care
mortality
surgery
outcomes
morbidity
access
rates
Surgery

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