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November 2015

Raising the Bar for Failure to Rescue: Critical Appraisal of Current Measurement and Strategies to Catalyze Improvement

Author Affiliations
  • 1Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
  • 2Division of Critical Care Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
  • 3Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
JAMA Surg. 2015;150(11):1023-1024. doi:10.1001/jamasurg.2015.1933

Failure to rescue (FTR), the death rate among patients with postoperative complications, is an emerging surgical quality metric that has received increased focus in the last several years.1 Medicare has begun publicly reporting FTR on Hospital Compare, and the National Quality Forum has endorsed 3 separate FTR measures.2 Despite this great promise and rapid adoption, considerably less attention has been paid to the way in which FTR is measured and what the measurement of FTR is intended to achieve. Despite the surge in interest within the surgical community in the last several years, current FTR measures have remained largely unchanged. In our view, the primary purpose of FTR measurement is to spur quality improvement, yet several issues remain with the way FTR is measured that limit its utility as a quality improvement tool. We summarize several key issues and suggest strategies to address these limitations.

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