High reliability systems associated with lower mortality

There are a number of studies indicating that surgery performed at high volume centers is associated with better outcomes than those performed at low volume centers. This study, however, indicates that it has more to do with the reliability of the system than the volume. In this large retrospective analysis of over 80,000 patients who underwent a CABG, researchers found a strong association between death, and the number of peri-operative quality measures missed (SCDs, beta blocker, ASA, statin, any antibiotic, and appropriate antibiotic), which was independent of hospital or surgeon volume. This indicates that the quality reliability of the hospital system is more important than the volume of the hospital system (abstract). The authors offer that it may be better to “shop for the best” instead of “following the crowd”

Danielle Scheurer

Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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