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Institution: University of Rochester, NY
Grant Title: Optimizing
Risk-Adjustment for Measuring ICU Quality
Grant Number: K08
Total Award: $350,300
Project Description: The purpose of this research was
to examine the feasibility of using risk-adjustment models for benchmarking
Intensive Care Unit (ICU) performance in a large multi-institutional database.
The major study hypothesis was that customization of three major ICU scoring
systems on the Identify of low and high performance ICUs. The study used an outcomes database created by the Society of Critical Care Medicine, and each of the three major ICU scoring systems: APACHE II (Acute Physiology and Chronic Health Evaluation), SAPS II (Simplified Acute Physiology Score), and MPM II (Mortality Probability Model).
Career Goals: Dr. Glance is an Associate Professor of Anesthesiology in the Department of Anesthesiology at the University of Rochester School of Medicine and Dentistry where he is also Vice-Chairman for Research. He received his MD from Cornell Medical College and did his residency in Anesthesiology at the New York Hospital. Dr. Glance also did a internship in Surgery at Tufts-New England Medical Center and a fellowship in Critical Care Medicine at Memorial Sloan-Kettering Center. His primary research interests are focused on understanding the opportunities and limitation of health care quality reporting.
Progress to Date: This grant has been
completed. Highlights from Dr. Glance's his research findings can be found in
publications listed below.
Highlights and Specific Accomplishments:
Cardiac Anesthesia Group, University of Rochester.
- Ad hoc reviewer for several professional journals.
- National Quality Forum Technical Advisory Panel on Hospital Care: Outcomes and Efficiency, 2009.
K-Generated Publications (selected):
Glance LG, Osler TM. Beyond the major trauma outcome study: Benchmarking
performance using a national contemporary, population-based trauma registry. Journal of Trauma 2001. 51(4):725-27.
Glance LG, Osler TM. Comparing outcomes of coronary artery
bypass surgery: Is the New York cardiac surgery reporting system model
sensitive to changes in case mix? Critical Care Medicine 2001. 29(11):2090-96.
Glance LG, Szalados JE. Benchmarking in critical care: The road
ahead. Chest 2002. 121(2):326-28.
Glance LG, Osler TM, Dick A. Rating the quality of ICUs—Is it
a function of the ICU scoring system? Critical Care Medicine 2002
Glance LG, Osler TM, Dick A. Identifying quality outliers in a
large multi-institutional database using customized versions of SAPS II and MPM
II. Critical Care Medicine 2002. 30(9):1995-2002.
Glance LG, Dick A, Mukamel D, Osler TM. Is the hospital
volume-mortality relationship in coronary artery bypass surgery the same for
low-risk versus high-risk patients? Annals of Thoracic Surgery 2003.
Glance LG, Dick AW, Mukamel D, Osler TM. The use of
hierarchical modeling to assess ICU quality. Intensive Care Medicine 2003.
Glance LG, Dick A, Osler TM, et al. Judging trauma center
quality: Does it depend on the choice of outcomes? Journal of Trauma 2004.
Glance LG, Osler TM, Dick A, Mukamel D. The relationship
between trauma center outcome and volume in the national trauma databank. Journal of Trauma 2004. 56(3):682-90.
Glance LG, Osler TM, Dick AW. Evaluating trauma center quality:
Does the choice of the severity-adjustment model make a difference? Journal of Trauma 2004 Jun. 58(6):1265-71.
Healey C, Osler TM, Rogers
FB, Kealy MA, Glance LG, et al. Improving the Glascow coma score: Motor
score alone is a better predictor. Journal of Trauma 2003. 54(4):671-80.
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