The value of monitoring outcomes should be measured by the appropriateness of the response 英文参考文献.docVIP
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The value of monitoring outcomes should be measured by the appropriateness of the response 英文参考文献
Available online /content/10/2/133
Commentary
The value of monitoring outcomes should be measured by the
appropriateness of the response
Timothy P Hofer
VA Health Services Research Development Center of Excellence, and Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
Corresponding author: Tim Hofer, thofer@
Published: 29 March 2006
Critical Care 2006, 10:133 (doi:10.1186/cc4872)
This article is online at /content/10/2/133
? 2006 BioMed Central Ltd
See related research by Cockings et al. in issue 10.1 [/content/10/1/R28]
Abstract
rapidly with suitable investigation and corrective strategies if
necessary.’
Real-time
monitoring of outcomes is becoming increasingly
feasible in health care, and with it the hope of early detection of
problems and the ability to tell whether interventions are having
their desired effect. The next step should be to try to demonstrate
that the reports of such monitoring systems lead to reasonable
responses and valid inferences about causality, and that we are not
chasing red herrings.
The real allure of these methods is that we may be able to
achieve a new level of insight by linking trends in outcomes to
specific calendar dates and sequences of patients. It is
believed that this will allow local personnel to utilize their
knowledge of what is going on day-to-day in a particular
organizational unit as an additional explanatory factor for the
observed temporal variations in outcomes. It is acknowledged
by some of these same authors elsewhere [2] that, given the
A high-profile patient managed by a high-profile doctor has a
bad outcome. Within the same month, but at different
geographical locations within a medical center, two surgical
procedures are conducted at the wrong anatomical site. In a
monitoring programme it is noted that an intensive care unit
(ICU) has ‘more deaths than expected
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