The value of process measures in evaluating an evidence-based guideline

Karen Brasel, John A. Weigelt, Kathleen K. Christians, Lewis B. Somberg, Anna M. Ledgerwood, Thomas I. Howard, Karen J. Brasel

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background. Linking the process of evidence-based guidelines to outcomes is difficult. We hypothesized that the process of implementing an evidence-based clinical guideline for blunt splenic trauma would reduce resource consumption and improve outcome. Methods. Time periods were divided into period 1 (7/1/96-6/30/99) and period 2 (7/1/99-6/30/01). On 7/1/99 our American College of Surgeons-verified level I trauma center instituted an evidence-based approach for managing splenic trauma incorporating hemodynamic normality as the process measure triggering clinical decisions. Outcomes included the number of hemodynamically normal patients treated without operation, patient death, length of stay, and cost. Results. Two hundred thirty-one patients had blunt splenic injury; 115 patients were seen during period 1 and 116 during period 2. Hemodynamically normal patients undergoing splenectomy decreased during period 2 (P <.05). Median length of stay was 8 days in period 1 and 6 days in period 2 (P <.03). Cost per patient was $34,972 in period 1 and $24,037 in period 2 (P <.03). The mortality rate was unchanged. Conclusions. Compliance with evidence-based data in the management of blunt splenic injury improved rates of nonoperative management, decreased hospital days, and did not change mortality rates. An evidence-based clinical guideline evaluated with process measures can reduce resource use and improve outcome in a trauma program.

Original languageEnglish (US)
Pages (from-to)605-612
Number of pages8
JournalSurgery
Volume134
Issue number4
DOIs
StatePublished - Oct 2003
Externally publishedYes

Fingerprint

Process Assessment (Health Care)
Guidelines
Nonpenetrating Wounds
Length of Stay
Wounds and Injuries
Costs and Cost Analysis
Mortality
Trauma Centers
Splenectomy
Hemodynamics

ASJC Scopus subject areas

  • Surgery

Cite this

Brasel, K., Weigelt, J. A., Christians, K. K., Somberg, L. B., Ledgerwood, A. M., Howard, T. I., & Brasel, K. J. (2003). The value of process measures in evaluating an evidence-based guideline. Surgery, 134(4), 605-612. https://doi.org/10.1016/S0039-6060(03)00339-8

The value of process measures in evaluating an evidence-based guideline. / Brasel, Karen; Weigelt, John A.; Christians, Kathleen K.; Somberg, Lewis B.; Ledgerwood, Anna M.; Howard, Thomas I.; Brasel, Karen J.

In: Surgery, Vol. 134, No. 4, 10.2003, p. 605-612.

Research output: Contribution to journalArticle

Brasel, K, Weigelt, JA, Christians, KK, Somberg, LB, Ledgerwood, AM, Howard, TI & Brasel, KJ 2003, 'The value of process measures in evaluating an evidence-based guideline', Surgery, vol. 134, no. 4, pp. 605-612. https://doi.org/10.1016/S0039-6060(03)00339-8
Brasel K, Weigelt JA, Christians KK, Somberg LB, Ledgerwood AM, Howard TI et al. The value of process measures in evaluating an evidence-based guideline. Surgery. 2003 Oct;134(4):605-612. https://doi.org/10.1016/S0039-6060(03)00339-8
Brasel, Karen ; Weigelt, John A. ; Christians, Kathleen K. ; Somberg, Lewis B. ; Ledgerwood, Anna M. ; Howard, Thomas I. ; Brasel, Karen J. / The value of process measures in evaluating an evidence-based guideline. In: Surgery. 2003 ; Vol. 134, No. 4. pp. 605-612.
@article{dfea04ec06c1438c837439c3eac2353d,
title = "The value of process measures in evaluating an evidence-based guideline",
abstract = "Background. Linking the process of evidence-based guidelines to outcomes is difficult. We hypothesized that the process of implementing an evidence-based clinical guideline for blunt splenic trauma would reduce resource consumption and improve outcome. Methods. Time periods were divided into period 1 (7/1/96-6/30/99) and period 2 (7/1/99-6/30/01). On 7/1/99 our American College of Surgeons-verified level I trauma center instituted an evidence-based approach for managing splenic trauma incorporating hemodynamic normality as the process measure triggering clinical decisions. Outcomes included the number of hemodynamically normal patients treated without operation, patient death, length of stay, and cost. Results. Two hundred thirty-one patients had blunt splenic injury; 115 patients were seen during period 1 and 116 during period 2. Hemodynamically normal patients undergoing splenectomy decreased during period 2 (P <.05). Median length of stay was 8 days in period 1 and 6 days in period 2 (P <.03). Cost per patient was $34,972 in period 1 and $24,037 in period 2 (P <.03). The mortality rate was unchanged. Conclusions. Compliance with evidence-based data in the management of blunt splenic injury improved rates of nonoperative management, decreased hospital days, and did not change mortality rates. An evidence-based clinical guideline evaluated with process measures can reduce resource use and improve outcome in a trauma program.",
author = "Karen Brasel and Weigelt, {John A.} and Christians, {Kathleen K.} and Somberg, {Lewis B.} and Ledgerwood, {Anna M.} and Howard, {Thomas I.} and Brasel, {Karen J.}",
year = "2003",
month = "10",
doi = "10.1016/S0039-6060(03)00339-8",
language = "English (US)",
volume = "134",
pages = "605--612",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - The value of process measures in evaluating an evidence-based guideline

AU - Brasel, Karen

AU - Weigelt, John A.

AU - Christians, Kathleen K.

AU - Somberg, Lewis B.

AU - Ledgerwood, Anna M.

AU - Howard, Thomas I.

AU - Brasel, Karen J.

PY - 2003/10

Y1 - 2003/10

N2 - Background. Linking the process of evidence-based guidelines to outcomes is difficult. We hypothesized that the process of implementing an evidence-based clinical guideline for blunt splenic trauma would reduce resource consumption and improve outcome. Methods. Time periods were divided into period 1 (7/1/96-6/30/99) and period 2 (7/1/99-6/30/01). On 7/1/99 our American College of Surgeons-verified level I trauma center instituted an evidence-based approach for managing splenic trauma incorporating hemodynamic normality as the process measure triggering clinical decisions. Outcomes included the number of hemodynamically normal patients treated without operation, patient death, length of stay, and cost. Results. Two hundred thirty-one patients had blunt splenic injury; 115 patients were seen during period 1 and 116 during period 2. Hemodynamically normal patients undergoing splenectomy decreased during period 2 (P <.05). Median length of stay was 8 days in period 1 and 6 days in period 2 (P <.03). Cost per patient was $34,972 in period 1 and $24,037 in period 2 (P <.03). The mortality rate was unchanged. Conclusions. Compliance with evidence-based data in the management of blunt splenic injury improved rates of nonoperative management, decreased hospital days, and did not change mortality rates. An evidence-based clinical guideline evaluated with process measures can reduce resource use and improve outcome in a trauma program.

AB - Background. Linking the process of evidence-based guidelines to outcomes is difficult. We hypothesized that the process of implementing an evidence-based clinical guideline for blunt splenic trauma would reduce resource consumption and improve outcome. Methods. Time periods were divided into period 1 (7/1/96-6/30/99) and period 2 (7/1/99-6/30/01). On 7/1/99 our American College of Surgeons-verified level I trauma center instituted an evidence-based approach for managing splenic trauma incorporating hemodynamic normality as the process measure triggering clinical decisions. Outcomes included the number of hemodynamically normal patients treated without operation, patient death, length of stay, and cost. Results. Two hundred thirty-one patients had blunt splenic injury; 115 patients were seen during period 1 and 116 during period 2. Hemodynamically normal patients undergoing splenectomy decreased during period 2 (P <.05). Median length of stay was 8 days in period 1 and 6 days in period 2 (P <.03). Cost per patient was $34,972 in period 1 and $24,037 in period 2 (P <.03). The mortality rate was unchanged. Conclusions. Compliance with evidence-based data in the management of blunt splenic injury improved rates of nonoperative management, decreased hospital days, and did not change mortality rates. An evidence-based clinical guideline evaluated with process measures can reduce resource use and improve outcome in a trauma program.

UR - http://www.scopus.com/inward/record.url?scp=0242467403&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0242467403&partnerID=8YFLogxK

U2 - 10.1016/S0039-6060(03)00339-8

DO - 10.1016/S0039-6060(03)00339-8

M3 - Article

C2 - 14605621

AN - SCOPUS:0242467403

VL - 134

SP - 605

EP - 612

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 4

ER -