Postoperative Respiratory Failure: An Update on the Validity of the Agency for Healthcare Research and Quality Patient Safety Indicator 11 in an Era of Clinical Documentation Improvement Programs

Overview

Journal Am J Surg

Specialty General Surgery

Date 2019 Nov 24

PMID 31757440

Citations 6

Authors

Jacqueline C Stocking

Garth H Utter

Christiana Drake

J Matthew Aldrich

Michael K Ong

Alpesh Amin

Rebecca A Marmor

Laura Godat

Maxime Cannesson

Michael A Gropper

Patrick S Romano

Affiliations

Soon will be listed here.

Abstract

Background: Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity of PSI 11. We also analyzed reasons why PSI 11 was falsely triggered.

Study Design: Cross-sectional study of all eligible discharges using health record data from five academic medical centers between October 1, 2012 and September 30, 2015.

Results: Of 437 flagged records, 434 (99.3%) were accurately coded and 414 (94.7%) represented true clinical PRF. None of the false positive records involved respiratory failure present on admission. Most (78.3%) false positive records required airway protection but did not have respiratory failure.

Conclusion: The validity of PSI 11 has improved with recent changes to the code criterion and adoption of clinical documentation improvement programs.

Citing Articles

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Outcomes and risk factors for delayed-onset postoperative respiratory failure: a multi-center case-control study by the University of California Critical Care Research Collaborative (UCRC).

Stocking J, Drake C, Aldrich J, Ong M, Amin A, Marmor R BMC Anesthesiol. 2022; 22(1):146.

PMID: 35568812 PMC: 9107656. DOI: 10.1186/s12871-022-01681-x.

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