Assessing clinical discharge data preferences among practicing surgeons

Abstract Background It is believed that many postoperative patient readmissions can be curbed via optimization of a patient's discharge from hospital, but little is known about how surgeons make the decision to discharge a patient. This study explored the criteria that surgeons preferentially v...

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Veröffentlicht in:The Journal of surgical research 2013-09, Vol.184 (1), p.42-48.e3
Hauptverfasser: Leeds, Ira L., MBA, Sadiraj, Vjollca, PhD, Cox, James C., PhD, Schnier, Kurt E., PhD, MA, Sweeney, John F., MD, FACS
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container_end_page 48.e3
container_issue 1
container_start_page 42
container_title The Journal of surgical research
container_volume 184
creator Leeds, Ira L., MBA
Sadiraj, Vjollca, PhD
Cox, James C., PhD
Schnier, Kurt E., PhD, MA
Sweeney, John F., MD, FACS
description Abstract Background It is believed that many postoperative patient readmissions can be curbed via optimization of a patient's discharge from hospital, but little is known about how surgeons make the decision to discharge a patient. This study explored the criteria that surgeons preferentially value in their discharge decision-making process. Materials and methods All surgical faculty and residents at a U.S. academic medical center were surveyed about the relative importance of specific criteria regularly used to make a discharge decision. Demographic and professional information was collected about each surgeon as well. A Kruskal–Wallis and Fisher's exact test were used to describe one-way analysis of variance between groupings of surgeons. Ordered logit regressions were used to analyze variations across multiple subgroups. Factor analysis was used to further characterize statistically relevant groupings of criteria. Results In total, 88 (49%) of the invited surgeons responded to the survey. Respondents reported statistically less reliance on common Laboratory tests and Patient demographics when making discharge decisions preferring Vital signs, Perioperative factors, and Functional criteria. Surgeon-specific factors that influenced discharge criteria preferences included years of clinical education and gender. Factor analysis further identified subtle variations in preferences for specific criteria groupings based on clinical education, gender, and race. Conclusions Surgeons use a wide range of clinical data when making discharge decisions. Typical measures of patient condition also appear to be used heterogeneously with a preference for binary rather than continuous measures. Further understanding the nature of these preferences may suggest novel ways of presenting discharge-relevant information to clinical decision makers to optimize discharge outcomes.
doi_str_mv 10.1016/j.jss.2013.03.064
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This study explored the criteria that surgeons preferentially value in their discharge decision-making process. Materials and methods All surgical faculty and residents at a U.S. academic medical center were surveyed about the relative importance of specific criteria regularly used to make a discharge decision. Demographic and professional information was collected about each surgeon as well. A Kruskal–Wallis and Fisher's exact test were used to describe one-way analysis of variance between groupings of surgeons. Ordered logit regressions were used to analyze variations across multiple subgroups. Factor analysis was used to further characterize statistically relevant groupings of criteria. Results In total, 88 (49%) of the invited surgeons responded to the survey. Respondents reported statistically less reliance on common Laboratory tests and Patient demographics when making discharge decisions preferring Vital signs, Perioperative factors, and Functional criteria. Surgeon-specific factors that influenced discharge criteria preferences included years of clinical education and gender. Factor analysis further identified subtle variations in preferences for specific criteria groupings based on clinical education, gender, and race. Conclusions Surgeons use a wide range of clinical data when making discharge decisions. Typical measures of patient condition also appear to be used heterogeneously with a preference for binary rather than continuous measures. Further understanding the nature of these preferences may suggest novel ways of presenting discharge-relevant information to clinical decision makers to optimize discharge outcomes.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2013.03.064</identifier><identifier>PMID: 23706559</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Academic Medical Centers ; Adult ; Attitude of Health Personnel ; Clinical decision-making ; Decision Making ; Decision support ; Decision Support Techniques ; Discharge ; Female ; General Surgery ; Health Care Surveys ; Hospital readmission ; Humans ; Logistic Models ; Male ; Medical Staff, Hospital - psychology ; Ordered logit regression ; Patient Discharge - standards ; Patient Discharge - statistics &amp; numerical data ; Patient Readmission - standards ; Patient Readmission - statistics &amp; numerical data ; Physicians - psychology ; Risk Factors ; Surgery ; Surgical outcomes</subject><ispartof>The Journal of surgical research, 2013-09, Vol.184 (1), p.42-48.e3</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><rights>2013 Elsevier Inc. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c506t-9f117b4dc822e1d96e6d300f5327025947fdc99e739d29bfda02ee74178df2a83</citedby><cites>FETCH-LOGICAL-c506t-9f117b4dc822e1d96e6d300f5327025947fdc99e739d29bfda02ee74178df2a83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2013.03.064$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23706559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leeds, Ira L., MBA</creatorcontrib><creatorcontrib>Sadiraj, Vjollca, PhD</creatorcontrib><creatorcontrib>Cox, James C., PhD</creatorcontrib><creatorcontrib>Schnier, Kurt E., PhD, MA</creatorcontrib><creatorcontrib>Sweeney, John F., MD, FACS</creatorcontrib><title>Assessing clinical discharge data preferences among practicing surgeons</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Abstract Background It is believed that many postoperative patient readmissions can be curbed via optimization of a patient's discharge from hospital, but little is known about how surgeons make the decision to discharge a patient. This study explored the criteria that surgeons preferentially value in their discharge decision-making process. Materials and methods All surgical faculty and residents at a U.S. academic medical center were surveyed about the relative importance of specific criteria regularly used to make a discharge decision. Demographic and professional information was collected about each surgeon as well. A Kruskal–Wallis and Fisher's exact test were used to describe one-way analysis of variance between groupings of surgeons. Ordered logit regressions were used to analyze variations across multiple subgroups. Factor analysis was used to further characterize statistically relevant groupings of criteria. Results In total, 88 (49%) of the invited surgeons responded to the survey. Respondents reported statistically less reliance on common Laboratory tests and Patient demographics when making discharge decisions preferring Vital signs, Perioperative factors, and Functional criteria. Surgeon-specific factors that influenced discharge criteria preferences included years of clinical education and gender. Factor analysis further identified subtle variations in preferences for specific criteria groupings based on clinical education, gender, and race. Conclusions Surgeons use a wide range of clinical data when making discharge decisions. Typical measures of patient condition also appear to be used heterogeneously with a preference for binary rather than continuous measures. Further understanding the nature of these preferences may suggest novel ways of presenting discharge-relevant information to clinical decision makers to optimize discharge outcomes.</description><subject>Academic Medical Centers</subject><subject>Adult</subject><subject>Attitude of Health Personnel</subject><subject>Clinical decision-making</subject><subject>Decision Making</subject><subject>Decision support</subject><subject>Decision Support Techniques</subject><subject>Discharge</subject><subject>Female</subject><subject>General Surgery</subject><subject>Health Care Surveys</subject><subject>Hospital readmission</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical Staff, Hospital - psychology</subject><subject>Ordered logit regression</subject><subject>Patient Discharge - standards</subject><subject>Patient Discharge - statistics &amp; numerical data</subject><subject>Patient Readmission - standards</subject><subject>Patient Readmission - statistics &amp; 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numerical data</topic><topic>Patient Readmission - standards</topic><topic>Patient Readmission - statistics &amp; numerical data</topic><topic>Physicians - psychology</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leeds, Ira L., MBA</creatorcontrib><creatorcontrib>Sadiraj, Vjollca, PhD</creatorcontrib><creatorcontrib>Cox, James C., PhD</creatorcontrib><creatorcontrib>Schnier, Kurt E., PhD, MA</creatorcontrib><creatorcontrib>Sweeney, John F., MD, FACS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leeds, Ira L., MBA</au><au>Sadiraj, Vjollca, PhD</au><au>Cox, James C., PhD</au><au>Schnier, Kurt E., PhD, MA</au><au>Sweeney, John F., MD, FACS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing clinical discharge data preferences among practicing surgeons</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>184</volume><issue>1</issue><spage>42</spage><epage>48.e3</epage><pages>42-48.e3</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>Abstract Background It is believed that many postoperative patient readmissions can be curbed via optimization of a patient's discharge from hospital, but little is known about how surgeons make the decision to discharge a patient. 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Surgeon-specific factors that influenced discharge criteria preferences included years of clinical education and gender. Factor analysis further identified subtle variations in preferences for specific criteria groupings based on clinical education, gender, and race. Conclusions Surgeons use a wide range of clinical data when making discharge decisions. Typical measures of patient condition also appear to be used heterogeneously with a preference for binary rather than continuous measures. Further understanding the nature of these preferences may suggest novel ways of presenting discharge-relevant information to clinical decision makers to optimize discharge outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23706559</pmid><doi>10.1016/j.jss.2013.03.064</doi><oa>free_for_read</oa></addata></record>
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subjects Academic Medical Centers
Adult
Attitude of Health Personnel
Clinical decision-making
Decision Making
Decision support
Decision Support Techniques
Discharge
Female
General Surgery
Health Care Surveys
Hospital readmission
Humans
Logistic Models
Male
Medical Staff, Hospital - psychology
Ordered logit regression
Patient Discharge - standards
Patient Discharge - statistics & numerical data
Patient Readmission - standards
Patient Readmission - statistics & numerical data
Physicians - psychology
Risk Factors
Surgery
Surgical outcomes
title Assessing clinical discharge data preferences among practicing surgeons
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