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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">This article describes the methods and conclusions of the first Spanish benchmarking study of thoracic surgery&#46; The proposed aims were to describe cases of lung resection in 9 Spanish hospitals&#44; compare indicators of quality among the 9 participating centers&#44; and identify and propose common areas where lung-resection processes could be improved&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Information was taken from the minimum basic data set for lobectomy and pneumonectomy processes performed in 2002 and 2003&#46; The chosen outcome indicators were in-hospital mortality&#44; morbidity&#44; length of hospital stay&#44; and emergency readmissions within 30 days of discharge&#44; adjusted according to surgical complexity&#46; Once the results had been analyzed&#44; the participating centers with best outcomes were identified and a variety of proposed improvements were discussed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 1666 procedures &#40;1276 lobectomies and 390 pneumectomies&#41; were studied&#46; We found differences in mean length of stay&#44; mortality&#44; readmission rate&#44; and morbidity that identified centers with lower mortality or shorter hospital stay for comparable or more complex surgical procedures&#46; However&#44; higher morbidity and readmission rates were found in these centers&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Measures were proposed to ensure that relevant diagnostic information is recorded on discharge&#46; It was also proposed to reduce unnecessarily long hospital stays and to standardize the procedures&#46; With such an approach&#44; reliable criteria that improve the quality of lung-resection processes can be established in the future&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">En el presente art&#237;culo se describen los m&#233;todos y las conclusiones del primer estudio espa&#241;ol de <span class="elsevierStyleItalic">benchmarking</span> en cirug&#237;a tor&#225;cica&#46; Los objetivos propuestos fueron&#58; describir la casu&#237;stica de resecci&#243;n pulmonar desarrollada en 9 hospitales espa&#241;oles&#44; comparar indicadores de calidad entre los 9 centros participantes e identificar y proponer &#225;reas de mejora comunes para los procesos de resecci&#243;n pulmonar&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se utiliz&#243; como fuente de informaci&#243;n el conjunto m&#237;nimo b&#225;sico de datos de los a&#241;os 2002 y 2003 de los procesos de lobectom&#237;a o neumonectom&#237;a&#46; Los indicadores de resultados seleccionados fueron&#58; mortalidad hospitalaria&#44; morbilidad&#44; estancia y readmisiones urgentes en los 30 d&#237;as siguientes al alta&#44; ajustadas por complejidad de los casos&#46; Una vez presentados los resultados entre los participantes&#44; se identificaron las unidades con mejores resultados y se discutieron diversas propuestas de mejora&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha estudiado un total de 1&#46;666 procedimientos &#40;1&#46;276 lobectom&#237;as y 390 neumonectom&#237;as&#41;&#46; Se de-tectaron diferencias en estancia media&#44; mortalidad&#44; tasa de readmisiones y morbilidad&#44; que permitieron identificar unidades&#44; de complejidad equiparable o superior&#44; con baja mortalidad y estancia&#46; Sin embargo&#44; en estas unidades se apreciaron tasas de morbilidad y readmisi&#243;n m&#225;s elevadas&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Se propusieron medidas encaminadas a registrar todos los diagn&#243;sticos relevantes en los informes de alta&#44; disminuir las estancias inadecuadas y estandarizar los procedimientos que permitir&#225;n en el futuro establecer criterios fiables para mejorar la calidad de los procesos de resecci&#243;n pulmonar&#46;</p>"
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Journal Information
Vol. 42. Issue 6.
Pages 267-272 (June 2006)
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Vol. 42. Issue 6.
Pages 267-272 (June 2006)
Original Articles
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Pilot Benchmarking Study of Thoracic Surgery in Spain: Comparison of Cases of Lung Resection and Indicators of Quality
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4076
Gonzalo Varelaa,
Corresponding author
gvs@usal.es

Correspondence: Dr. G. Varela. Sección de Cirugía Torácica. Hospital Universitario de Salamanca. P.° de San Vicente, 58–182. 37007 Salamanca. España
, Laureano Molinsb, Julio Astudilloc, José María Borrod, Emilio Canalíse, Jorge Freixinetf, Carlos Hernández Ortizg, Florentino Hernando Tranchoh, José Antonio Maestrei
a Hospital Universitario, Salamanca, Spain
b Hospital Universitari Sagrat Cor, Barcelona, Spain
c Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
d Complejo Hospitalario Juan Canalejo, A Coruña, Spain
e Hospital Clínic i Provincial, Barcelona, Spain
f Hospital de Canarias Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
g Hospital Donostia, San Sebastián, Spain
h Hospital Clínico San Carlos, Madrid, Spain
i Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Objective

This article describes the methods and conclusions of the first Spanish benchmarking study of thoracic surgery. The proposed aims were to describe cases of lung resection in 9 Spanish hospitals, compare indicators of quality among the 9 participating centers, and identify and propose common areas where lung-resection processes could be improved.

Methods

Information was taken from the minimum basic data set for lobectomy and pneumonectomy processes performed in 2002 and 2003. The chosen outcome indicators were in-hospital mortality, morbidity, length of hospital stay, and emergency readmissions within 30 days of discharge, adjusted according to surgical complexity. Once the results had been analyzed, the participating centers with best outcomes were identified and a variety of proposed improvements were discussed.

Results

A total of 1666 procedures (1276 lobectomies and 390 pneumectomies) were studied. We found differences in mean length of stay, mortality, readmission rate, and morbidity that identified centers with lower mortality or shorter hospital stay for comparable or more complex surgical procedures. However, higher morbidity and readmission rates were found in these centers.

Conclusions

Measures were proposed to ensure that relevant diagnostic information is recorded on discharge. It was also proposed to reduce unnecessarily long hospital stays and to standardize the procedures. With such an approach, reliable criteria that improve the quality of lung-resection processes can be established in the future.

Key words:
Lung resection
Health care benchmarking
Clinical pathways
Quality of clinical practice
Objetivo

En el presente artículo se describen los métodos y las conclusiones del primer estudio español de benchmarking en cirugía torácica. Los objetivos propuestos fueron: describir la casuística de resección pulmonar desarrollada en 9 hospitales españoles, comparar indicadores de calidad entre los 9 centros participantes e identificar y proponer áreas de mejora comunes para los procesos de resección pulmonar.

Métodos

Se utilizó como fuente de información el conjunto mínimo básico de datos de los años 2002 y 2003 de los procesos de lobectomía o neumonectomía. Los indicadores de resultados seleccionados fueron: mortalidad hospitalaria, morbilidad, estancia y readmisiones urgentes en los 30 días siguientes al alta, ajustadas por complejidad de los casos. Una vez presentados los resultados entre los participantes, se identificaron las unidades con mejores resultados y se discutieron diversas propuestas de mejora.

Resultados

Se ha estudiado un total de 1.666 procedimientos (1.276 lobectomías y 390 neumonectomías). Se de-tectaron diferencias en estancia media, mortalidad, tasa de readmisiones y morbilidad, que permitieron identificar unidades, de complejidad equiparable o superior, con baja mortalidad y estancia. Sin embargo, en estas unidades se apreciaron tasas de morbilidad y readmisión más elevadas.

Conclusiones

Se propusieron medidas encaminadas a registrar todos los diagnósticos relevantes en los informes de alta, disminuir las estancias inadecuadas y estandarizar los procedimientos que permitirán en el futuro establecer criterios fiables para mejorar la calidad de los procesos de resección pulmonar.

Palabras clave:
Resección pulmonar
Benchmarking sanitario
Vías clínicas
Calidad de lapráctica clínica
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Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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