Benchmarking in Thoracic Surgery. Third Edition

• Published in: Archivos de bronconeumología (English ed.) Vol. 52; no. 4; pp. 204 - 210
• Main Authors: Freixinet Gilart, Jorge, Varela Simó, Gonzalo, Rodríguez Suárez, Pedro, Embún Flor, Raúl, Rivas de Andrés, Juan José, de la Torre Bravos, Mercedes, Molins López-Rodó, Laureano, Pac Ferrer, Joaquín, Izquierdo Elena, José Miguel, Baschwitz, Benno, López de Castro, Pedro E, Fibla Alfara, Juan José, Hernando Trancho, Florentino, Carvajal Carrasco, Ángel, Canalís Arrayás, Emili, Salvatierra Velázquez, Ángel, Canela Cardona, Mercedes, Torres Lanzas, Juan, Moreno Mata, Nicolás
• Format: Journal Article
• Language: English; Spanish
• Published: 01.04.2016
• ISSN: 1579-2129
• DOI: 10.1016/j.arbres.2015.09.014

INTRODUCTIONBenchmarking entails continuous comparison of efficacy and quality among products and activities, with the primary objective of achieving excellence.OBJECTIVETo analyze the results of benchmarking performed in 2013 on clinical practices undertaken in 2012 in 17 Spanish thoracic surgery units.METHODSStudy data were obtained from the basic minimum data set for hospitalization, registered in 2012. Data from hospital discharge reports were submitted by the participating groups, but staff from the corresponding departments did not intervene in data collection. Study cases all involved hospital discharges recorded in the participating sites. Episodes included were respiratory surgery (Major Diagnostic Category 04, Surgery), and those of the thoracic surgery unit. Cases were labelled using codes from the International Classification of Diseases, 9th revision, Clinical Modification. The refined diagnosis-related groups classification was used to evaluate differences in severity and complexity of cases.RESULTSGeneral parameters (number of cases, mean stay, complications, readmissions, mortality, and activity) varied widely among the participating groups. Specific interventions (lobectomy, pneumonectomy, atypical resections, and treatment of pneumothorax) also varied widely.CONCLUSIONSAs in previous editions, practices among participating groups varied considerably. Some areas for improvement emerge: admission processes need to be standardized to avoid urgent admissions and to improve pre-operative care; hospital discharges should be streamlined and discharge reports improved by including all procedures and complications. Some units have parameters which deviate excessively from the norm, and these sites need to review their processes in depth. Coding of diagnoses and comorbidities is another area where improvement is needed.