Background: There is considerable recent interest in the monitoring of individual surgeon or hospital surgical outcomes. If one aggregates data over time and assesses performance with a funnel plot, then the detection of any process deterioration or improvement could be delayed. The variable life adjusted display (VLAD) is widely used for monitoring on a case-by-case basis, but we show that use of the risk-adjusted Bernoulli cumulative sum (RA-CUSUM) chart leads to much better performance. Discussion: We use simulation to illustrate that the RA-CUSUM chart has better performance than the VLAD in detecting changes in the rates of adverse events. Summary: We recommend the RA-CUSUM approach over the VLAD approach for monitoring surgical performance. If the VLAD is used, we recommend running the RA-CUSUM chart in the background to generate signals that the process performance has changed.
CITATION STYLE
Steiner, S. H., & Woodall, W. H. (2016, April 5). Debate: What is the best method to monitor surgical performance? BMC Surgery. BioMed Central. https://doi.org/10.1186/s12893-016-0131-8
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