title: Assessment of postoperative pulmonary embolism as a measure of patient care.
abstract: Hospitals presenting voluntarily for accreditation survey during 1993 submitted data on pulmonary embolism to the Australian Council on Health Care Standard (ACHS) Care Evaluation Program (CEP) as a part of their medical quality activities. The data were stratified by hospital type and bed-size, and compared to the provisional threshold of 1%. The mean duration of data collection was 24 weeks (range 8-74 weeks). Of hospitals with bed-size 1-50, 77% observed a zero pulmonary embolism rate. Hospitals with zero and non-zero pulmonary embolism rates were significantly different with respect to bed-size (P = 0.001). The rarity of pulmonary embolism and lack of prospective continuous monitoring poses considerable problems in interpretation of aggregate rates. Hospitals with a high patient throughout should continuously monitor their pulmonary embolism data to achieve a large denominator. For smaller hospitals with a low performance of major operations, collection of data on this clinical indicator is unlikely to be useful as a measure of quality of care.
authors.affiliation: ACHS Care Evaluation Program, St Vincents Hospital, Fitzroy, Vic., Australia.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Ansari
authors.forename: B T
authors.initials: BT
authors.lastname: Collopy
mesh_terms: D000068:Accreditation / Q000592:standards; D001315:Australia / Q000453:epidemiology; D016009:Chi-Square Distribution; D006742:Hospital Bed Capacity; D016304:Hospitals, Private / Q000592:standards*; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D007902:Length of Stay; D016012:Poisson Distribution; D011182:Postoperative Care / Q000592:standards*; D011183:Postoperative Complications / Q000453:epidemiology*; D011655:Pulmonary Embolism / Q000453:epidemiology*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D018401:Sample Size