Institute for QI releases benchmarks
Cataract, colonoscopy, and knee arthroscopy targeted
The AAAAHC Institute for Quality Improvement (IQI) has released the clinical versions of three benchmarking study reports: cataract extraction with lens insertion, colonoscopy, and knee arthro-scopy with meniscectomy.
Clinical reports include data on factors such as outcomes, complications, and patient satisfaction, as well as operative techniques, anesthesia and policies and procedures that improve efficiency and reduce patient wait times. Here are the results:
• Cataract surgery.
Intraoperative anesthetic techniques include topical (42%), peribulbar block (24%), retrobulbar block (26%).
Individuals insured by Medicare were less likely to receive high-tech replacement lenses that also correct presbyopia (15%) compared to non-Medicare-eligible patients who received the corrective reading lens (28%).
Two weeks following surgery, 95% of patients said their vision had changed for the better. Almost all patients (99%) said they understood the procedure and what was going to happen to them, were comfortable during and after the procedure, and would recommend the procedure to friends or family members with cataracts. The vast majority (97%) said they were able to return to their activities of daily living within one week, with 76% reporting resumption of activities within two days.
• Colonoscopy.
In 94% of cases, a time was given for visualization of the cecum. In 80% of the cases, the time from cecum visualization to the end of the procedure was six minutes or more.The average time from the visualization of the cecum to the end of the procedure (by organization) ranged from four to 18 minutes, with a median of nine minutes. The 2002 U.S. Multi-Society Task Force on Colorectal Cancer recommended that the withdrawal phase for colonoscopy should average at least six to 10 minutes.
Only 2% of patients reported "almost severe" or "severe discomfort" during the procedure itself; however 15% reported discomfort with bowel preparation techniques prior to the procedure. Of those who reported significant discomfort with the bowel preparation, 8% said they would not have the procedure again.
• Knee Arthroscopy with Meniscectomy.
Almost half (45%) of procedures were performed due to traumatic injury, and 55% were due to degenerative disease.
Average discharge time ranged from about 94 minutes for patients receiving epidural/spinal anesthesia to 66 minutes with local anesthesia and IV sedation.
Of 576 patients who remembered their procedures, 97.7% said they were comfortable during the surgery. All but 35 (5%) indicated they had begun walking at the time they were surveyed (within seven days of the procedure).
Reports may be ordered online. Go to www.aaahc.org and click on "AAAHC Institute for Quality Improvement" and then "order products." They are available in an e-mailed PDF format ($95) and CD-ROM ($120 plus $13 shipping).
The AAAAHC Institute for Quality Improvement (IQI) has released the clinical versions of three benchmarking study reports: cataract extraction with lens insertion, colonoscopy, and knee arthro-scopy with meniscectomy.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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