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Cramm, Shannon L; Graham, Dionne A; Blakely, Martin L; Cowles, Robert A; Kunisaki, Shaun M; Lipskar, Aaron M; Russell, Robert T; Santore, Matthew T; DeFazio, Jennifer R; Griggs, Cornelia L; Aronowitz, Danielle I.; Allukian, Myron; Campbell, Brendan T; Chandler, Nicole M; Collins, Devon T; Commander, Sarah J; Dukleska, Katerina; Echols, Justice C; Esparaz, Joseph R; Feng, Christina; Gerall, Claire; Hanna, David N; Keane, Olivia A; McLean, Sean E; [...]

Utility of a Benchmarking Report for Balancing Infection Prevention and Antimicrobial Stewardship in Children with Complicated Appendicitis

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  • Medientyp: E-Artikel
  • Titel: Utility of a Benchmarking Report for Balancing Infection Prevention and Antimicrobial Stewardship in Children with Complicated Appendicitis
  • Beteiligte: Cramm, Shannon L; Graham, Dionne A; Blakely, Martin L; Cowles, Robert A; Kunisaki, Shaun M; Lipskar, Aaron M; Russell, Robert T; Santore, Matthew T; DeFazio, Jennifer R; Griggs, Cornelia L; Aronowitz, Danielle I.; Allukian, Myron; Campbell, Brendan T; Chandler, Nicole M; Collins, Devon T; Commander, Sarah J; Dukleska, Katerina; Echols, Justice C; Esparaz, Joseph R; Feng, Christina; Gerall, Claire; Hanna, David N; Keane, Olivia A; McLean, Sean E; [...]
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2024
  • Erschienen in: Annals of Surgery (2024)
  • Sprache: Englisch
  • DOI: 10.1097/sla.0000000000006246
  • ISSN: 0003-4932
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: Objective: To develop a severity-adjusted, hospital-level benchmarking comparative performance report for postoperative organ space infection and antibiotic utilization in children with complicated appendicitis. Background: No benchmarking data exist to aid hospitals in identifying and prioritizing opportunities for infection prevention or antimicrobial stewardship in children with complicated appendicitis. Methods: This was a multicenter cohort study using NSQIP-Pediatric data from 16 hospitals participating in a regional research consortium, augmented with antibiotic utilization data obtained through supplemental chart review. Children with complicated appendicitis who underwent appendectomy from 07/01/2015 to 06/30/2020 were included. Thirty-day postoperative OSI rates and cumulative antibiotic utilization were compared between hospitals using observed-to-expected (O/E) ratios after adjusting for disease severity using mixed effects models. Hospitals were considered outliers if the 95% confidence interval for O/E ratios did not include 1.0. Results: 1790 patients were included. Overall, the OSI rate was 15.6% (hospital range: 2.6-39.4%) and median cumulative antibiotic utilization was 9.0 days (range: 3.0-13.0). Across hospitals, adjusted O/E ratios ranged 5.7-fold for OSI (0.49-2.80, P=0.03) and 2.4-fold for antibiotic utilization (0.59-1.45, P<0.01). Three (19%) hospitals were outliers for OSI (1 high and 2 low performers), and eight (50%) were outliers for antibiotic utilization (5 high and 3 low utilizers). Ten (63%) hospitals were identified as outliers in one or both measures. Conclusions: A comparative performance benchmarking report may help hospitals identify and prioritize quality improvement opportunities for infection prevention and antimicrobial stewardship, as well as identify exemplar performers for dissemination of best practices.