Emergency readmissions after breast surgery: can we trust Model Hospital?
Association of Breast Surgery ePoster Library. Dalal A. 05/13/19; 257098; P054
Dr. Ayesha Dalal
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P054
Topic: Breast surgery
Introduction: Model Hospital (MH) is a digital tool introduced by NHS Improvement. NHS Trusts are expected to use this to drive improvements in productivity and outcomes by benchmarking their results against national results. A review revealed Royal Devon and Exeter as an outlier for 30 day readmissions. This was identified as the largest opportunity for improvement. We carried out a review of coded unplanned emergency admissions within 30 days of breast operations. Methods :Data was collected for a 21month period from January 2016 to September 2018. All consecutive patients who underwent breast surgery by Breast surgeons were included and those with an unplanned admission within 30 days underwent further review. The reason for readmission was crosschecked with clinical notes and discharge summaries. Results:2245 admission episodes for breast surgery were recorded for 5 Breast surgeons. Overall readmission rate was recorded at 4.14%(93) and readmission with direct surgical complications was 2.18%(49). 25 of these were day attendances at the surgical assessment unit. Surgical complications seen were 42.8%(21) with infection, 22.5%(11) with haematoma, 12.2%(6) with seroma and 8.2%(4) with pain. 47.3%(44) reported readmissions were due to unrelated medical problems, chemotherapy complications or data errors.Conclusion:The results available on MH are not a true reflection of our outcomes due to inaccuracies in the data uploaded. 236 patients reported to MH had not had breast surgery. Only a quarter of reported readmissions were true overnight admissions relating to surgical complications.
Topic: Breast surgery
Introduction: Model Hospital (MH) is a digital tool introduced by NHS Improvement. NHS Trusts are expected to use this to drive improvements in productivity and outcomes by benchmarking their results against national results. A review revealed Royal Devon and Exeter as an outlier for 30 day readmissions. This was identified as the largest opportunity for improvement. We carried out a review of coded unplanned emergency admissions within 30 days of breast operations. Methods :Data was collected for a 21month period from January 2016 to September 2018. All consecutive patients who underwent breast surgery by Breast surgeons were included and those with an unplanned admission within 30 days underwent further review. The reason for readmission was crosschecked with clinical notes and discharge summaries. Results:2245 admission episodes for breast surgery were recorded for 5 Breast surgeons. Overall readmission rate was recorded at 4.14%(93) and readmission with direct surgical complications was 2.18%(49). 25 of these were day attendances at the surgical assessment unit. Surgical complications seen were 42.8%(21) with infection, 22.5%(11) with haematoma, 12.2%(6) with seroma and 8.2%(4) with pain. 47.3%(44) reported readmissions were due to unrelated medical problems, chemotherapy complications or data errors.Conclusion:The results available on MH are not a true reflection of our outcomes due to inaccuracies in the data uploaded. 236 patients reported to MH had not had breast surgery. Only a quarter of reported readmissions were true overnight admissions relating to surgical complications.
P054
Topic: Breast surgery
Introduction: Model Hospital (MH) is a digital tool introduced by NHS Improvement. NHS Trusts are expected to use this to drive improvements in productivity and outcomes by benchmarking their results against national results. A review revealed Royal Devon and Exeter as an outlier for 30 day readmissions. This was identified as the largest opportunity for improvement. We carried out a review of coded unplanned emergency admissions within 30 days of breast operations. Methods :Data was collected for a 21month period from January 2016 to September 2018. All consecutive patients who underwent breast surgery by Breast surgeons were included and those with an unplanned admission within 30 days underwent further review. The reason for readmission was crosschecked with clinical notes and discharge summaries. Results:2245 admission episodes for breast surgery were recorded for 5 Breast surgeons. Overall readmission rate was recorded at 4.14%(93) and readmission with direct surgical complications was 2.18%(49). 25 of these were day attendances at the surgical assessment unit. Surgical complications seen were 42.8%(21) with infection, 22.5%(11) with haematoma, 12.2%(6) with seroma and 8.2%(4) with pain. 47.3%(44) reported readmissions were due to unrelated medical problems, chemotherapy complications or data errors.Conclusion:The results available on MH are not a true reflection of our outcomes due to inaccuracies in the data uploaded. 236 patients reported to MH had not had breast surgery. Only a quarter of reported readmissions were true overnight admissions relating to surgical complications.
Topic: Breast surgery
Introduction: Model Hospital (MH) is a digital tool introduced by NHS Improvement. NHS Trusts are expected to use this to drive improvements in productivity and outcomes by benchmarking their results against national results. A review revealed Royal Devon and Exeter as an outlier for 30 day readmissions. This was identified as the largest opportunity for improvement. We carried out a review of coded unplanned emergency admissions within 30 days of breast operations. Methods :Data was collected for a 21month period from January 2016 to September 2018. All consecutive patients who underwent breast surgery by Breast surgeons were included and those with an unplanned admission within 30 days underwent further review. The reason for readmission was crosschecked with clinical notes and discharge summaries. Results:2245 admission episodes for breast surgery were recorded for 5 Breast surgeons. Overall readmission rate was recorded at 4.14%(93) and readmission with direct surgical complications was 2.18%(49). 25 of these were day attendances at the surgical assessment unit. Surgical complications seen were 42.8%(21) with infection, 22.5%(11) with haematoma, 12.2%(6) with seroma and 8.2%(4) with pain. 47.3%(44) reported readmissions were due to unrelated medical problems, chemotherapy complications or data errors.Conclusion:The results available on MH are not a true reflection of our outcomes due to inaccuracies in the data uploaded. 236 patients reported to MH had not had breast surgery. Only a quarter of reported readmissions were true overnight admissions relating to surgical complications.
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