title: Benchmarking in Thoracic Surgery. Third Edition.
abstract: BACKGROUND
  Benchmarking entails continuous comparison of efficacy and quality among products and activities, with the primary objective of achieving excellence.
  
  
  OBJECTIVE
  To analyze the results of benchmarking performed in 2013 on clinical practices undertaken in 2012 in 17 Spanish thoracic surgery units.
  
  
  METHODS
  Study data were obtained from the basic minimum data set for hospitalization, registered in 2012. Data from hospital discharge reports were submitted by the participating groups, but staff from the corresponding departments did not intervene in data collection. Study cases all involved hospital discharges recorded in the participating sites. Episodes included were respiratory surgery (Major Diagnostic Category 04, Surgery), and those of the thoracic surgery unit. Cases were labelled using codes from the International Classification of Diseases, 9th revision, Clinical Modification. The refined diagnosis-related groups classification was used to evaluate differences in severity and complexity of cases.
  
  
  RESULTS
  General parameters (number of cases, mean stay, complications, readmissions, mortality, and activity) varied widely among the participating groups. Specific interventions (lobectomy, pneumonectomy, atypical resections, and treatment of pneumothorax) also varied widely.
  
  
  CONCLUSIONS
  As in previous editions, practices among participating groups varied considerably. Some areas for improvement emerge: admission processes need to be standardized to avoid urgent admissions and to improve pre-operative care; hospital discharges should be streamlined and discharge reports improved by including all procedures and complications. Some units have parameters which deviate excessively from the norm, and these sites need to review their processes in depth. Coding of diagnoses and comorbidities is another area where improvement is needed.
authors.affiliation: Unidad de Cirugía Torácica, Hospital Universitario Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España. Electronic address: jfregil@gobiernodecanarias.org.
authors.forename: Jorge
authors.initials: J
authors.lastname: Freixinet Gilart
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Varela Simó
authors.affiliation: Unidad de Cirugía Torácica, Hospital Universitario Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Rodríguez Suárez
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Raúl
authors.initials: R
authors.lastname: Embún Flor
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Rivas de Andrés
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Juan Canalejo, La Coruña, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: de la Torre Bravos
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitari Clínic i Provincial de Barcelona, Barcelona, España.
authors.forename: Laureano
authors.initials: L
authors.lastname: Molins López-Rodó
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Pac Ferrer
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Izquierdo Elena
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Alicante, Alicante, España.
authors.forename: Benno
authors.initials: B
authors.lastname: Baschwitz
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Pedro E
authors.initials: PE
authors.lastname: López de Castro
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitari Sagrat Cor, Barcelona, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Fibla Alfara
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: Florentino
authors.initials: F
authors.lastname: Hernando Trancho
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Carvajal Carrasco
authors.affiliation: Unidad de Cirugía Torácica, Hospital Universitario Joan XXII de Tarragona, Tarragona, España.
authors.forename: Emili
authors.initials: E
authors.lastname: Canalís Arrayás
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Salvatierra Velázquez
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Canela Cardona
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Torres Lanzas
authors.affiliation: Servicio de Cirugía Torácica. Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, España.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Moreno Mata
mesh_terms: D019985:Benchmarking; D006801:Humans; D013030:Spain; D019616:Thoracic Surgical Procedures / Q000592:standards*
keywords: Benchmarking; Cirugía torácica; Lobectomy; Lobectomía; Lung resections; Resecciones pulmonares; Thoracic surgery