Clinical performance and quality health care
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Clin Perform Qual Health Care · Jan 1999
Red blood cell transfusions for elective hip and knee arthroplasty: opportunity to improve quality of care and documentation.
To assess current practice for red blood cell transfusion relative to the American College of Physicians guideline for red blood cell transfusion; to determine comparative rates and relative appropriateness of autologous versus allogeneic blood use; and, to assess cost implications of current transfusion practices. ⋯ These findings demonstrate that current medical records lack the documentation necessary to evaluate transfusion practice for the majority of Medicare beneficiaries undergoing elective hip and knee arthroplasty. The direct costs of preoperative and postoperative blood transfusion for these two procedures could be reduced by nearly 40% through adherence to the American College of Physicians guideline. The majority of this cost saving would be realized through reduction in unnecessary collection and use of autologous blood.
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Clin Perform Qual Health Care · Jan 1999
Counterpoint: public disclosure of process and outcome measures.
Bad data is a toxic substance. In the release of process and outcome measures in the field of health care, numerous examples exist of published bad data. ⋯ Such procedures include appropriate definitions of the process or outcome to be measured and careful description of the population being observed, risk adjusted for severity of illness. When this is done, the data can be published with some confidence that it will have value.