Private Performance Feedback Report for Pediatric Adenotonsillectomy

小儿腺样体扁桃体切除术的私人绩效反馈报告

• 批准号: 9249480
• 负责人: Jeremy Meier
• 金额: $ 4.74万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9249480
• 关键词: Private; Performance; Feedback; Report; Pediatric

 DESCRIPTION (provided by applicant): Appropriately incentivizing surgeons to increase efficiency by delivering higher quality care at a lower cost could significantly improve the value of healthcare delivery in the United States. In this proposal, a private performance feedback report for surgeons performing pediatric adenotonsillectomy (T&A) is tested as a non- financial incentive to improve surgeon and system performance. This report includes postoperative outcomes, perioperative process measures, and costs. A pilot program within the Intermountain Healthcare system, in preparation for this award, has provided surgeons with an initial report allowing each surgeon to compare his or her data to hospital and system averages. Adenotonsillectomy (T&A) is the most common major operation performed in children in the US. However, there remains significant geographic, hospital, and surgeon variation in outcomes and costs for this procedure. Intermountain Healthcare maintains a unique Enterprise Data Warehouse (EDW) that contains administrative, financial (including both costs and charges), and clinical data. Costs are derived from the Standard Cost Master, the hospital's cost-accounting program. This is a transaction-based micro-costing system that identifies and aggregates the variable- and fixed-cost components of patient activities, hospital services, and products according to the date of service. Our previous research has demonstrated variation in T&A costs per surgeon across the Intermountain Healthcare system and found that surgeons with higher costs did not necessarily achieve better outcomes, suggesting that variation in surgeon efficiency and performance exist. A pilot private performance feedback report for surgeons performing pediatric T&A has been introduced to surgeons. This report includes average patient satisfaction scores, frequency of adherence to national guidelines for steroid and antibiotic administration, frequency of postoperative complications, and the mean cost of care per case. This application will use an interrupted time-series analysis to determine the efficacy of quarterly reports given to surgeons in improving outcomes and/or reducing costs. Qualitative analysis using study groups will be performed to better understand from a surgeon's perspective the effectiveness of this report. The ultimate goal of this application is to evaluate the efficacy of a private performance feedback report containing outcomes, clinical process measures, and costs in improving surgeon and system efficiency for pediatric T&A. This study will help us better understand how, why, and under what conditions private reporting improves surgeon performance. Applying this approach to other common pediatric surgical conditions can improve health outcomes and reduce costs across the United States.

 描述（由适用提供）：以较低的成本提供更高质量的护理，可以适当提高外科医生，以提高效率，这可以显着提高美国医疗保健提供的价值。在该提案中，针对执行小儿腺乳房切除术（T＆A）的外科医生的私人绩效反馈报告被视为改善外科医生和系统绩效的非财务激励措施。该报告包括术后结果，定期过程措施和成本。为了准备该奖项，在Intermountain Healthcare系统中进行的试点计划为外科医生提供了初步报告，允许每个外科医生将其数据与医院和系统平均值进行比较。腺苷切除术（T＆A）是美国儿童最常见的主要手术。但是，此程序的结局和成本上仍然存在重大的地理，医院和外科医生的差异。 Intermountain Healthcare保留了一个独特的企业数据仓库（EDW），其中包含行政，财务（包括费用和费用）和临床数据。成本来自标准成本大师，这是医院的成本调查计划。这是一个基于交易的微观成本系统，可根据服务日期确定并汇总患者活动，医院服务和产品的可变成本和固定成本组件。我们以前的研究表明，整个座位医疗保健系统中，每位外科医生的T＆A成本差异，发现成本较高的外科医生并不一定取得更好的结果，这表明外科医生效率和表现的差异存在。为外科医生介绍了一份针对外科医生的试点私人绩效反馈报告。该报告包括平均患者满意度评分，遵守国家类固醇和抗生素给药指南的频率，术后并发症的频率以及每例平均护理成本。该应用程序将使用中断的时间序列分析来确定向外科医生改善结果和/或降低成本的季度报告的有效性。将进行研究小组的定性分析，以从外科医生的角度更好地理解本报告的有效性。该应用程序的最终目标是评估包含结果，临床过程指标以及提高小儿T＆A外科医生和系统效率的私人绩效反馈报告的有效性。这项研究将帮助我们更好地了解私人报告如何，为什么以及在什么条件下改善外科医生的绩效。将这种方法应用于其他常见的儿科手术状况可以改善健康状况并降低整个美国的成本。