2.50
Hdl Handle:
http://hdl.handle.net/10755/159078
Type:
Presentation
Title:
Exploratory Analyses of the "Failure to Rescue" Measure
Abstract:
Exploratory Analyses of the "Failure to Rescue" Measure
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Talsma, AkkeNeel, PhD, RN
P.I. Institution Name:University of Michigan
Title:Assistant Professor
Contact Address:School of Nursing, 400 North Ingalls, Ann Arbor, MI, 48109-0482, USA
Contact Telephone:734-764-8152
Co-Authors:Susan M. Beidler, PhD, ARNP, Assistant Professor
Purpose. National emphasis on performance measures necessitates proper identification of Failure to Rescue (FTR) cases. Our purpose was to compare the AHRQ and NQF defined FTR cases. Framework. Recent studies have shown a relationship between FTR rates and nursing staffing ratios in large population based analyses. This study validated FTR cases through hospital level analyses. Subjects. Included cases were identified through AHRQ prepared SAS logic, using ICD-9CM and CPT codes from billing data. Survivors and expired cases of the FTR indicator were included in the analyses. Methods. Administrative data were obtained from the University of Michigan Health System Data Warehouse. FTR rates were computed for 1999-2002 using the AHRQ-HCUP developed logic. Exploratory analyses comparing AHRQ and NQF cases were based on 2002 FTR cases (n=2,001). Random selection of 20% of identified AHRQ-FTR expired cases underwent online case reviews. Statistical analyses were applied to understand differences between cases. Results. The coded complication was confirmed for 80% of the AHRQ-FTR defined cases. Current FTR logic does not exclude cases with high-risk pre-existing comorbid conditions, i.e. oncology cases. NQF-FTR cases only include surgical cases and no cases with acute renal failure complications. Over 70% of the AHRQ and NQF FTR expired cases showed the highest risk of mortality, vs 18% and 23%, resp. of the surviving AHRQ-FTR and NQF-FTR cases. The unadjusted AHRQ and NQF rates were nearly identical (ns) but the NQF rate comprised only 14% of the AHRQ FTR population. Conclusions. The validity of the current FTR measure is questionable as this population is very sensitive to documentation and coding practices. Risk of mortality is not evenly distributed among cases. The few NQF-FTR defined cases in a large academic hospital limit the evaluation of a nursing staffing impact. Stratification of complications was meaningful to identify improvement opportunities.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleExploratory Analyses of the "Failure to Rescue" Measureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159078-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Exploratory Analyses of the &quot;Failure to Rescue&quot; Measure</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Talsma, AkkeNeel, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Michigan</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">School of Nursing, 400 North Ingalls, Ann Arbor, MI, 48109-0482, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">734-764-8152</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">antalsma@umich.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Susan M. Beidler, PhD, ARNP, Assistant Professor</td></tr><tr><td colspan="2" class="item-abstract">Purpose. National emphasis on performance measures necessitates proper identification of Failure to Rescue (FTR) cases. Our purpose was to compare the AHRQ and NQF defined FTR cases. Framework. Recent studies have shown a relationship between FTR rates and nursing staffing ratios in large population based analyses. This study validated FTR cases through hospital level analyses. Subjects. Included cases were identified through AHRQ prepared SAS logic, using ICD-9CM and CPT codes from billing data. Survivors and expired cases of the FTR indicator were included in the analyses. Methods. Administrative data were obtained from the University of Michigan Health System Data Warehouse. FTR rates were computed for 1999-2002 using the AHRQ-HCUP developed logic. Exploratory analyses comparing AHRQ and NQF cases were based on 2002 FTR cases (n=2,001). Random selection of 20% of identified AHRQ-FTR expired cases underwent online case reviews. Statistical analyses were applied to understand differences between cases. Results. The coded complication was confirmed for 80% of the AHRQ-FTR defined cases. Current FTR logic does not exclude cases with high-risk pre-existing comorbid conditions, i.e. oncology cases. NQF-FTR cases only include surgical cases and no cases with acute renal failure complications. Over 70% of the AHRQ and NQF FTR expired cases showed the highest risk of mortality, vs 18% and 23%, resp. of the surviving AHRQ-FTR and NQF-FTR cases. The unadjusted AHRQ and NQF rates were nearly identical (ns) but the NQF rate comprised only 14% of the AHRQ FTR population. Conclusions. The validity of the current FTR measure is questionable as this population is very sensitive to documentation and coding practices. Risk of mortality is not evenly distributed among cases. The few NQF-FTR defined cases in a large academic hospital limit the evaluation of a nursing staffing impact. Stratification of complications was meaningful to identify improvement opportunities.</td></tr></table>en_GB
dc.date.available2011-10-26T21:40:55Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:40:55Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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