Background: Centralization of complex surgeries has made little progress when it only considers the minimum number of surgical procedures. We aim to assess the impact of certification system of Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) on centralization and surgical quality of advanced hepato-pancreatic-biliary (HPB) surgery.
Methods: The National Clinical Database was used to review 20 111 patients who underwent pancreatoduodenectomy (PD) and 9666 who underwent advanced hepatectomy defined as hepatectomy of more than one section during 2019 and 2020. JSHPBS certifies hospitals based on the annual number of advanced HPB surgeries and the surgical quality. Minimum numbers of surgeries for board-certified A and B institutions are 50 and 30, respectively. Short-term outcomes were compared among institutions.
Results: In 2020, 69.4% (7007/10090) and 72.9% (3433/4710) of patients underwent PD and advanced hepatectomy at board-certified institutions. In-hospital mortality rates after PD was 0.9% at certified A institutions, 1.4% at B institutions, and 2.7% at non-certified institutions (p < .001). The odds ratio (OR) of risk-adjusted mortality after PD compared with non-certified institutions was 0.39 (confidence interval [CI]: 0.30-0.50, p < .001) at certified A institutions, and 0.54 at certified B institutions (CI: 0.40-0.73, p < .001). In-hospital mortality rates after advanced hepatectomy was 1.7% at certified A institutions, 2.3% at B institutions, and 3.2% at non-certified institutions (p < .001). The OR of risk-adjusted mortality after advanced hepatectomy compared with non-certified institutions was 0.57 at certified A institutions (CI: 0.41-0.78, p < .001).
Conclusion: The volume- and quality-controlled certification system of JSHBPS reduces surgical mortality after advanced HPB surgeries.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/jhbp.1307 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Unified Mobile App for Streamlining Verbal Autopsy and Cause of Death Assignment in India: Design and Development Study.
JMIR Form Res
January 2025
ICMR-National Institute for Research in Digital Health and Data Science, Ansari Nagar, New Delhi, 110029, India, 91 7840870009.
Background: Verbal autopsy (VA) has been a crucial tool in ascertaining population-level cause of death (COD) estimates, specifically in countries where medical certification of COD is relatively limited. The World Health Organization has released an updated instrument (Verbal Autopsy Instrument 2022) that supports electronic data collection methods along with analytical software for assigning COD. This questionnaire encompasses the primary signs and symptoms associated with prevalent diseases across all age groups.
View Article and Find Full Text PDFFeO might be more suitable than Fe for the construction of anammox-dominated Fe-N coupling system: Based on N isotope tracing.
Water Res
January 2025
Beijing Key Laboratory of Aqueous Typical Pollutants Control and Water Quality Safeguard, School of Environment, Beijing Jiaotong University, Beijing, 100044, PR China. Electronic address:
Iron not only influences the activity of anammox bacteria (AnAOB) but also participates in complex Fe-N cycles. In this study, the advanced N isotope tracing method was set up to quantify the potential rates of full nitrogen metabolic pathways under different ferrous iron (Fe and FeO) within two identical anammox granular reactors. The results indicated that both Fe and FeO enhanced AnAOB activity.
View Article and Find Full Text PDFInterprofessional Collaboration as a Best Practice Across the Care Continuum.
Prof Case Manag
January 2025
Vivian Campagna, DNP, RN-BC, CCM, ICE-CCP is the Chief Industry Relations Officer of the Commission for Case Manager Certification, the first and largest nationally accredited organization that certifies more than 50,000 professional case managers and disability management specialists. The Commission oversees the process of case manager certification with its CCM® credential and disability management specialist certification with its CDMS® credential. With more than 30 years of case management experience, Vivian spent much of her professional career in acute care case management, prior to joining the Commission.
Purpose: Interprofessional teams are increasingly being recognized as a best practice for enhancing cooperation among multiple disciplines in delivering person-centered care and improving outcomes. Unlike previous models, such as the multidisciplinary team in which each profession or discipline remained largely siloed, with interprofessional teams collaboration occurs across disciplines. For case managers, the interprofessional team concept aligns with the collaborative, professionally diverse nature of the field of practice.
View Article and Find Full Text PDFQualitative evaluation of the implementation and national roll-out of the NHS App in England.
BMC Med
January 2025
Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Background: The NHS App launched in 2019 as the 'digital front door' to the National Health Service in England with core features including General Practitioner (GP) appointment booking, repeat prescriptions, patient access to records and, later on, COVID-19 vaccination certification. Similar patient portals have been adopted in different formats and with variable levels of success. In this longitudinal study (2021-2023) we examined how the NHS App became implemented in the pandemic context and beyond.
View Article and Find Full Text PDFThe impact of digital transformational leadership on digital intensity among primary healthcare entities: a moderated mediation model.
BMC Health Serv Res
January 2025
School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China.
Background: Uncertain times require healthcare entities to demonstrate strong leadership, develop digitalisation, and respond to change in a creative and flexible manner. Based on emerging new institutional theory, we developed and tested a model of how digital transformational leadership (DTL) affects digital intensity (DI) among healthcare entities through the mediating role of organisational agility (OA). In this article, we also examine the moderating role of the country in the studied relationship.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!