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Quality assessment in surgical care departments: proposal for a scoring system in terms of structure and process
  1. J Najjar-Pellet1,
  2. P Jambou2,
  3. O Jonquet3,
  4. J Fabry4
  1. 1NosoQual Project, Laboratoire d'Épidémiologie et Santé Publique, Université de Lyon, Lyon Cedex, France
  2. 2Coordination Hospitalière Prélèvements et Greffes d'Organes et de Tissus, Hôpital de Cimiez, CHU de Nice, Nice Cedex, France
  3. 3Réanimation Médicale & Assistance Respiratoire, CHRU Montpellier, Université Montpellier, Montpellier Cedex, France
  4. 4Centre de Coordination de la Lutte contre les Infections Nosocomiales (C.CLIN) Sud-Est and Laboratoire d'Épidémiologie et Santé Publique, Université de Lyon, Lyon Cedex, France
  1. Correspondence to Jacques Fabry, Laboratoire d'Épidémiologie et Santé Publique, Université de Lyon, 8 avenue Rockefeller F-69373 Lyon Cedex 08, France; jfabry{at}univ-lyon1.fr

Abstract

Objective To build a score able to reflect and rank surgical departments according to a definition of “quality” in terms of structure and process.

Methods Collaborative design of a quality score in the framework of the French clinical research project NosoQual. Feasibility and observational study in 46 surgical departments visited between November 2002 and March 2003 according to standardised procedures. A bibliographic review followed by expert consultations, a field test, analysis and a final reconsideration leading to the definition of a consensual score.

Results 138 variables comprised the score. They were classified into seven dimensions, each representing a different aspect of quality of care in surgery. According to the threshold and weight attributed to every variable, scores were calculated for each department. The average level of achievement of the scores varied from 42% to 71% of theoretical maxima. The variability of the scores related to the seven dimensions was larger and more significant than the one expressed by the overall score (coefficient of variation=0.1).

Conclusion This analytical work contributed to the design of a quality score for surgery. However, the progress of the score should continue to take into account all the obstacles that were observed and to meet the high requirements of the actual patient safety issue.

  • Surgical care
  • quality indicators
  • assessment
  • risk management
  • scoring
  • quality of care
  • surgery
  • statistics

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Footnotes

  • Competing interests None.

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