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Journal articleJarman B, Pieter D, van der Veen AA, et al., 2010,
The hospital standardised mortality ratio: a powerful tool for Dutch hospitals to assess their quality of care?
, QUALITY & SAFETY IN HEALTH CARE, Vol: 19, Pages: 9-13, ISSN: 1475-3898- Author Web Link
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- Citations: 82
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Journal articleFaiz O, Brown T, Bottle A, et al., 2010,
Impact of hospital institutional volume on postoperative mortality after major emergency colorectal surgery in English National Health Service Trusts, 2001 to 2005
, Diseases of the colon and rectum, Vol: 53, Pages: 393-401, ISSN: 1530-0358PURPOSE: The aim of this study was to investigate the effects of institutional volume on postoperative mortality in patients undergoing emergency major colorectal surgical procedures in England between 2001 and 2005. METHODS: All of the emergency excisional colorectal procedures performed between the above dates were included from the Hospital Episode Statistics data set. Institutions were divided into high-, medium-, and low-volume tertiles according to the total major emergency colorectal caseload. RESULTS: During the study period, 37,094 emergency excisional colorectal procedures were performed in 166 English National Health Service institutions. Overall 30-day postoperative mortality was 15.49%, increasing to 29.18% at 1 year after surgery. Overall 30- and 365-day mortality rates were similar among institutional volume tertiles (P > .05) after adjustment for age, sex, social deprivation, diagnosis, procedure type, and comorbidity score. CONCLUSION: Hospital Episode Statistics data suggest that institutions with high volumes of emergency colorectal caseload do not demonstrate lower mortality after emergency major excisional colorectal surgery.
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Conference paperBurns E, Naseem H, Aylin P, et al., 2010,
Trends in laparoscopic bariatric surgery and comparisons of outcomes with open surgery: a national study in England 2000-2008
, Electronic Poster of Distinction in Association-of-Surgeons-of-Great-Britain-and-Ireland-International-Surgical-Congress, Publisher: WILEY-BLACKWELL, Pages: 40-40, ISSN: 0007-1323 -
Conference paperBurns E, Bottle A, Faiz O, et al., 2010,
The role of volume in bariatric surgery
, Electronic Poster of Distinction in Association-of-Surgeons-of-Great-Britain-and-Ireland-International-Surgical-Congress, Publisher: WILEY-BLACKWELL, Pages: 72-72, ISSN: 0007-1323 -
Journal articleFaiz O, Warusavitarne J, Bottle A, et al., 2010,
Nonelective excisional colorectal surgery in English National Health Service Trusts: a study of outcomes from Hospital Episode Statistics Data between 1996 and 2007
, Journal of the American College of Surgeons, Vol: 210, Pages: 390-401, ISSN: 1879-1190BACKGROUND: Nonelective colorectal surgery is associated with substantial patient morbidity and mortality. This study sought to describe the practice of emergency colorectal surgery in the United Kingdom during an 11-year period using the Hospital Episode Statistics (HES) database. STUDY DESIGN: All nonelective admissions in patients undergoing 1 of 8 colorectal resectional procedures between 1996 and 2007 were included. Time trends, univariate, and multivariate mortality and length of stay outcomes were analyzed. RESULTS: A total of 102,236 major urgent/emergency procedures were performed in English National Health Service Trusts between April 1996 and March 2007. Thirty-day in-hospital postoperative mortality rates in patients with colorectal cancer and diverticular disease were 13.3% and 15.4%, respectively. The corresponding 1-year postoperative mortality was 34.7% and 22.6%. On multivariate analysis, benign diagnosis, advanced age, high comorbidity score, social deprivation, and specific procedure types were independent predictors of early and 1-year postoperative mortality (p < 0.001). Independent risk factors for extended hospital stay were advanced age, social deprivation, distal (compared with proximal) bowel resection, and a diagnosis of ulcerative colitis (p < 0.001). CONCLUSIONS: HES data suggest that in everyday practice, postoperative mortality among patients undergoing nonelective admission followed by colorectal resection is high. Additional investigation is required to assess the reliability of HES data for monitoring institutional variation in this context.
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Conference paperBurns EM, Bottle A, Aylin P, et al., 2010,
National outcomes following bariatric surgery in England
, Electronic Poster of Distinction in Association-of-Surgeons-of-Great-Britain-and-Ireland-International-Surgical-Congress, Publisher: WILEY-BLACKWELL, Pages: 8-8, ISSN: 0007-1323 -
Conference paperBurns E, Bottle A, Aylin P, et al., 2010,
Examining differences in case selection between surgeons with differing surgical caseload in pouch surgery
, Electronic Poster of Distinction in Association-of-Surgeons-of-Great-Britain-and-Ireland-International-Surgical-Congress, Publisher: WILEY-BLACKWELL, Pages: 131-131, ISSN: 0007-1323 -
Journal articleTsang C, Majeed A, Banarsee R, et al., 2010,
Recording of adverse events in English general practice: analysis of data from electronic patient records.
, Inform Prim Care, Vol: 18, Pages: 117-124, ISSN: 1476-0320BACKGROUND: Although the majority of patient contact within the UK's National Health Service (NHS) occurs in primary care, relatively little is known about the safety of care in this setting compared to the safety of hospital care. Measurement methods to detect iatrogenic diseases in primary care require extensive development. Routinely collected data have been successfully applied to develop patient safety indicators in secondary care. Given the availability of electronic health data in primary care, we explored the potential to build adverse event screening tools using computerised medical record systems. OBJECTIVE: To identify the rate and types of adverse events that might be recorded in primary care through routinely collected data. The findings will inform the development of administrative data-based indicators to screen for patient harm arising from primary care contact. METHOD: Descriptive analyses were performed on data extracted from the clinical information management systems (CIMS) at NHS Brent. The data were explored according to age, sex and ethnicity of patients. Potential or actual adverse events were identified by mapping to three Read code chapters. RESULTS: Records from the calendar year 2007 were available for 69 682 registered patients from 25 practices, consisting of 680 866 consultations. A number of adverse events could be detected through terms contained in certain chapters of the Read code system. These events include injuries due to surgical and medical care (0.72 cases of per 1000 consultations) and adverse drug reactions (1.26 reactions per 1000 consultations). Patterns in the rate of harm among patients from different ethnic groups tended to reflect the proportion of the respective groups in the overall Brent population, with more injuries occurring among patients of white and Asian ethnicities. CONCLUSION: These findings suggest that there is scope to develop more accurate and reliable means of safety surveillance in general practice u
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Journal articleJen MH, Bottle A, Majeed A, et al., 2009,
Early in-hospital mortality following trainee doctors' first day at work
, PLOS One, Vol: 4, ISSN: 1932-6203BackgroundThere is a commonly held assumption that early August is an unsafe period to be admitted to hospital in England, as newly qualified doctors start work in NHS hospitals on the first Wednesday of August. We investigate whether in-hospital mortality is higher in the week following the first Wednesday in August than in the previous week.MethodologyA retrospective study in England using administrative hospital admissions data. Two retrospective cohorts of all emergency patients admitted on the last Wednesday in July and the first Wednesday in August for 2000 to 2008, each followed up for one week.Principal FindingsThe odds of death for patients admitted on the first Wednesday in August was 6% higher (OR 1.06, 95% CI 1.00 to 1.15, p = 0.05) after controlling for year, gender, age, socio-economic deprivation and co-morbidity. When subdivided into medical, surgical and neoplasm admissions, medical admissions admitted on the first Wednesday in August had an 8% (OR 1.08, 95% CI 1.01 to 1.16, p = 0.03) higher odds of death. In 2007 and 2008, when the system for junior doctors' job applications changed, patients admitted on Wednesday August 1st had 8% higher adjusted odds of death than those admitted the previous Wednesday, but this was not statistically significant (OR 1.08, 95% CI 0.95 to 1.23, p = 0.24).ConclusionsWe found evidence that patients admitted on the first Wednesday in August have a higher early death rate in English hospitals compared with patients admitted on the previous Wednesday. This was higher for patients admitted with a medical primary diagnosis.
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Journal articleBrown C, Richards M, Galletly T, et al., 2009,
Use of anti-infective serial prevalence studies to identify and monitor hospital-acquired infection
, JOURNAL OF HOSPITAL INFECTION, Vol: 73, Pages: 34-40, ISSN: 0195-6701- Author Web Link
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- Citations: 7
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