American journal of medical quality : the official journal of the American College of Medical Quality
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The aim of this study was to determine if use of a standardized airway data collection sheet can survey airway management practices in an emergency department. Success rates and trends from the authors' facility have been benchmarked against the National Emergency Airway Registry (NEAR). This study included all patients requiring invasive airway management during a 21-month period (July 1, 2005, through March 31, 2007). ⋯ During the study period, 224 patients required invasive airway control. Of all airways managed by emergency medicine residents, the intubation success rate was 99% (200/203; 95% confidence interval [CI] = 96%-100%), with 3% of those (6/203; 95% CI = 1%-6%) requiring more than 3 attempts; 3 patients (1%; 95% CI = 0%-4%) could not be intubated and required a surgical airway. Use of an airway registry based on the NEAR registry as a benchmark of rates and types of successful intubation allows comparison of airway practices.
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Policy maker efforts to evaluate the quality and costs of health care have stimulated a proliferation of disparate performance measures. This cacophony of performance measures creates confusion over which measures are applicable at which level of the health care system, limiting their effective application for accountability and improvements in patient care. ⋯ Recommendation. The ACP recommends that policy makers and measure developers adopt this clinical performance measurement framework to promote transformational change and improve the quality of health care in the United States.