The value of monitoring outcomes should be measured by the appropriateness of the response 英文参考文献.docVIP

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