Featured Research

from universities, journals, and other organizations

Colorectal surgeons develop a novel tool for measuring quality and outcomes

Date:
September 26, 2013
Source:
University Hospitals Case Medical Center
Summary:
In a new paper, physician-researchers describe a new tool called the HARM score that reliably measures quality and clinical outcomes for colon and rectal surgery patients. The score is derived from Hospital stay, Readmission rate, and Mortality, and shows a strong correlation with quality of clinical outcomes for colon and rectal surgery patients.

Since the publication in 2000 of a report titled "To Err is Human" by the Institute of Medicine which called for a reduction in preventable medical errors, there has been an increasing demand for making improvements in the quality and measurement of health care outcomes. Although many measures have been developed, they tend to be complex, labor intensive, have an unclear relationship with improved outcomes, and concentrate on processes of care rather than clinical outcomes.

Related Articles


In a new paper published online by the Annals of Surgery, physician-researchers at University Hospitals Case Medical Center describe a new tool called the HARM score that reliably measures quality and clinical outcomes for colon and rectal surgery patients. The name of the tool reflects the data sources used to calculate the score: HospitAl stay, Readmission rate, and Mortality. The paper demonstrates a strong correlation between the HARM score, and the quality of clinical outcomes achieved by surgeons and hospitals for patients having major abdominal surgery.

"There is a need for a metric that accurately and inexpensively measures patient outcomes, effectiveness, and efficiency of care," said Conor P. Delaney, MD PhD, senior author of the study and Chief of the Division of Colorectal Surgery at University Hospitals Case Medical Center and Professor of Surgery at Case Western Reserve University School of Medicine.

"The HARM score is easy to measure, derived from routinely captured data elements, applicable to a variety of procedures, and serves as an impetus for continuous improvement," he said.

Previous work they published in the Journal of the American Medical Association in 2010 had demonstrated that the most utilized process measures had no relationship to outcomes. Dr. Delaney said that extensive research and long-term assessment and refinement that his group has now done on enhanced recovery in colorectal surgery led them to conclude that the most important measurements of quality are outcome measures, including length-of-stay (LOS), readmission rates, and mortality.

LOS has gained increasing attention as an indicator of surgical efficiency because consistent and safe reduction of this measure is usually the result of an effective, enhanced recovery program, said Dr. Delaney. LOS is an excellent surrogate marker for complication rates and increased healthcare use, making it a target for cost containment, too, he said.

Readmissions are also a key element to consider in a quality metric. "It is estimated that each readmission episode after colorectal surgery costs about $9,000, accounting for $300 million in readmission costs annually," said Dr. Delaney. Mortality is obviously a crucially important short-term outcomes measure and a benchmark for measuring quality of care, he said.

Dr. Delaney and his team tested the validity of the HARM score by doing a retrospective review of 81,600 colectomy discharge records from 324 hospitals between January 2010 and January 2011found in a national database. They evaluated complications, such as infection following surgery, bleeding, and several other categories. An analysis showed the complication rate directly correlated with the HARM score.

"In addition to the HARM tool being easy to use, the tool uses routinely available administrative data without either capital investment for software, or ongoing costs for maintenance or personnel. "The HARM score may decrease the administrative costs associated with quality care improvement programs, while being almost universally applicable regardless of the size of the hospital," said Dr. Delaney.

Dr. Delaney said that future studies on the HARM score will include applying it in clinical practice as well as comparisons to national inpatient data samples, and correlating the outcomes against other measures of quality to increase the validity of the score. The researchers conclude that the HARM score is a valid and reliable quality measurement for colon and rectal surgery patient outcomes which has significant implications for benchmarking quality of care.


Story Source:

The above story is based on materials provided by University Hospitals Case Medical Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Deborah S. Keller, Hung-Lun Chien, Lobat Hashemi, Anthony J. Senagore, Conor P. Delaney. The HARM Score. Annals of Surgery, 2013; 1 DOI: 10.1097/SLA.0b013e3182a6f45e

Cite This Page:

University Hospitals Case Medical Center. "Colorectal surgeons develop a novel tool for measuring quality and outcomes." ScienceDaily. ScienceDaily, 26 September 2013. <www.sciencedaily.com/releases/2013/09/130926131633.htm>.
University Hospitals Case Medical Center. (2013, September 26). Colorectal surgeons develop a novel tool for measuring quality and outcomes. ScienceDaily. Retrieved December 20, 2014 from www.sciencedaily.com/releases/2013/09/130926131633.htm
University Hospitals Case Medical Center. "Colorectal surgeons develop a novel tool for measuring quality and outcomes." ScienceDaily. www.sciencedaily.com/releases/2013/09/130926131633.htm (accessed December 20, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, December 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Best Tips to Curb Holiday Carbs

The Best Tips to Curb Holiday Carbs

Buzz60 (Dec. 19, 2014) It's hard to resist those delicious but fattening carbs we all crave during the winter months, but there are some ways to stay satisfied without consuming the extra calories. Vanessa Freeman (@VanessaFreeTV) has the details. Video provided by Buzz60
Powered by NewsLook.com
Sierra Leone Bikers Spread the Message to Fight Ebola

Sierra Leone Bikers Spread the Message to Fight Ebola

AFP (Dec. 19, 2014) More than 100 motorcyclists hit the road to spread awareness messages about Ebola. Nearly 7,000 people have now died from the virus, almost all of them in west Africa, according to the World Health Organization. Video provided by AFP
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
The Best Protein-Filled Foods to Energize You for the New Year

The Best Protein-Filled Foods to Energize You for the New Year

Buzz60 (Dec. 19, 2014) The new year is coming and nothing will energize you more for 2015 than protein-filled foods. Fitness and nutrition expert John Basedow (@JohnBasedow) gives his favorite high protein foods that will help you build muscle, lose fat and have endless energy. Video provided by Buzz60
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins