Abstract
The topic of quality touches every aspect of the work of a clinical surgeon. In order to appropriately discuss quality, mechanisms by which to measure quality need to be understood. Quality improvement does not end with quality measurement, however, and it is essential that data be used to drive continuous change in clinical care. Several different paradigms and ongoing examples of quality measurement and improvement approaches are discussed with a particular focus on those that have been applied in colorectal surgery. There is no single approach to quality that functions perfectly in all contexts, and the goal of this chapter is to guide the reader in developing an understanding of quality that reflects the complexity of this field and hopefully encourages broader participation in these activities by the greater colorectal surgery community. Ultimately, surgeons all want what is best for their patients, and the concepts described are designed for surgeons in their efforts to meet this goal.
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References
Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.
https://www.medicare.gov/hospitalcompare/search.html. Accessed 4 Mar 2020.
https://projects.propublica.org/surgeons/. Accessed 4 Mar 2020.
http://www.checkbook.org/surgeonratings/. Accessed 4 Mar 2020.
https://media.beam.usnews.com/da/5b/7646c0e744aea61f55e5aa816870/190709-bh-procedures-conditions-methodology-2019.pdf. Accessed 4 Mar 2020.
Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q. 1966;44:166–206.
Brennan N, Conway PH, Tavenner M. The Medicare physician-data release--context and rationale. N Engl J Med. 2014;371(2):99–101.
Etzioni DA, Wasif N, Dueck AC, Cima RR, Hohmann SF, Naessens JM, et al. Association of hospital participation in a surgical outcomes monitoring program with inpatient complications and mortality. JAMA. 2015;313(5):505–11.
Osborne NH, Nicholas LH, Ryan AM, Thumma JR, Dimick JB. Association of hospital participation in a quality reporting program with surgical outcomes and expenditures for Medicare beneficiaries. JAMA. 2015;313(5):496–504.
Fry DE. Prevention of infection at the surgical site. Surg Infect. 2017;18(4):377–8.
Munday GS, Deveaux P, Roberts H, Fry DE, Polk HC. Impact of implementation of the surgical care improvement project and future strategies for improving quality in surgery. Am J Surg. 2014;208(5):835–40.
Hawn MT, Vick CC, Richman J, Holman W, Deierhoi RJ, Graham LA, et al. Surgical site infection prevention: time to move beyond the surgical care improvement program. Ann Surg. 2011;254(3):494–9; discussion 9–501.
Stulberg JJ, Delaney CP, Neuhauser DV, Aron DC, Fu P, Koroukian SM. Adherence to surgical care improvement project measures and the association with postoperative infections. JAMA. 2010;303(24):2479–85.
Birkmeyer JD, Dimick JB, Birkmeyer NJ. Measuring the quality of surgical care: structure, process, or outcomes? J Am Coll Surg. 2004;198(4):626–32.
Lawson EH, Louie R, Zingmond DS, Brook RH, Hall BL, Han L, et al. A comparison of clinical registry versus administrative claims data for reporting of 30-day surgical complications. Ann Surg. 2012;256(6):973–81.
Lawson EH, Zingmond DS, Hall BL, Louie R, Brook RH, Ko CY. Comparison between clinical registry and medicare claims data on the classification of hospital quality of surgical care. Ann Surg. 2015;261(2):290–6.
Etzioni DA, Lessow CL, Lucas HD, Merchea A, Madura JA, Mahabir R, et al. Infectious surgical complications are not dichotomous: characterizing discordance between administrative data and registry data. Ann Surg. 2018;267(1):81–7.
https://data.medicare.gov/Hospital-Compare/NSQIP-HOSPITAL-COMPARE-DATA/c635-s3cy. Accessed 10 Mar 2020.
https://innovation.cms.gov/Files/fact-sheet/bpciadvanced-fs-psi90.pdf. Accessed 2 Mar 2020.
Ruchlin HS, Dubbs NL, Callahan MA. The role of leadership in instilling a culture of safety: lessons from the literature. J Healthc Manag. 2004;49(1):47–58; discussion -9.
Sexton JB, Thomas EJ, Helmreich RL. Error, stress, and teamwork in medicine and aviation: cross sectional surveys. BMJ. 2000;320(7237):745–9.
Amalberti R, Auroy Y, Berwick D, Barach P. Five system barriers to achieving ultrasafe health care. Ann Intern Med. 2005;142(9):756–64.
https://innovation.cms.gov/innovation-models/bpci-advanced. Accessed 4 May 2020.
Liao JM, Pauly MV, Navathe AS. When should medicare mandate participation in alternative payment models? Health Aff (Millwood). 2020;39(2):305–9.
El Chaar M, Claros L, Ezeji GC, Miletics M, Stoltzfus J. Improving outcome of bariatric surgery: best practices in an accredited surgical center. Obes Surg. 2014;24(7):1057–63.
Morton JM, Garg T, Nguyen N. Does hospital accreditation impact bariatric surgery safety? Ann Surg. 2014;260(3):504–8; discussion 8–9.
Young MT, Jafari MD, Gebhart A, Phelan MJ, Nguyen NT. A decade analysis of trends and outcomes of bariatric surgery in Medicare beneficiaries. J Am Coll Surg. 2014;219(3):480–8.
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/ncd103c1_Part2.pdf. Accessed 5 May 2020.
Dimick JB, Nicholas LH, Ryan AM, Thumma JR, Birkmeyer JD. Bariatric surgery complications before vs after implementation of a national policy restricting coverage to centers of excellence. JAMA. 2013;309(8):792–9.
https://www.facs.org/quality-programs/cancer/naprc. Accessed 4 May 2020.
https://www.facs.org/-/media/files/quality-programs/cancer/naprc/naprc-standards-manual.ashx. Accessed 5 May 2020.
Khuri SF, Daley J, Henderson W, Hur K, Demakis J, Aust JB, et al. The Department of Veterans Affairs’ NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program. Ann Surg. 1998;228(4):491–507.
Fink AS, Campbell DA Jr, Mentzer RM Jr, Henderson WG, Daley J, Bannister J, et al. The national surgical quality improvement program in non-veterans administration hospitals: initial demonstration of feasibility. Ann Surg. 2002;236(3):344–53; discussion 53–4.
Khuri SF, Henderson WG, Daley J, Jonasson O, Jones RS, Campbell DA Jr, et al. Successful implementation of the Department of Veterans Affairs’ national surgical quality improvement program in the private sector: the patient safety in surgery study. Ann Surg. 2008;248(2):329–36.
https://bulletin.facs.org/2018/12/ahrq-safety-program-for-iscr-expands-scope-in-2019/. Accessed 3 May 2020.
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Wick, E.C., Etzioni, D.A. (2022). Quality. In: Steele, S.R., Hull, T.L., Hyman, N., Maykel, J.A., Read, T.E., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-66049-9_71
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