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Design and implementation of the Americas Hernia Society Quality Collaborative (AHSQC): improving value in hernia care

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Abstract

Purpose

Wide variation in care and costs exists regarding the management of abdominal wall hernias, with unproven benefit for many therapies. This work establishes a specialty society-based solution to improve the quality and value of care delivered to hernia patients during routine clinical management on a national scale.

Methods

The Americas Hernia Society Quality Task Force was charged by the Americas Hernia Society leadership to develop an initiative that utilizes the concepts of continuous quality improvement (CQI). A disease-based registry was created to collect information for CQI incorporating real-time outcome reporting, patient reported outcomes, stakeholder engagement, and collaborative learning methods to form a comprehensive quality improvement effort.

Results

The Americas Hernia Society Quality Collaborative (AHSQC) was formed with the mission to provide health care professionals real-time information for maximizing value in hernia care. The initial disease areas selected for CQI were incisional and parastomal hernias with ten priorities encompassing the spectrum of care. A prospective registry was created with real-time analytic feedback to surgeons. A data assurance process was implemented to ensure maximal data quality and completeness. Four collaborative meetings per year were established to meet the goals of the AHSQC. As of the fourth quarter 2014, the AHSQC includes nearly 2377 patients at 38 institutions with 82 participating surgeons.

Conclusions

The AHSQC has been established as a quality improvement initiative utilizing concepts of CQI. This ongoing effort will continually refine its scope and goals based on stakeholder input to improve care delivered to hernia patients.

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Acknowledgments

We wish to thank the following for their continued support of the AHSQC: the Americas Hernia Society, Carol Goddard (AHS Executive Director), Mary Beth Brown, Shelby Dunstan (AHSQC Coordinator), and Howard Haenel (AHS and AHSQC legal counsel). We also with to thank Dr. Binita Ashar and Dr. George Gibeily of the United States Food and Drug Administration for their helpful suggestions for the AHSQC and future collaborative efforts as we move forward.

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Authors and Affiliations

  1. Department of Surgery, Vanderbilt University Medical Center, D-5203 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232, USA

    B. K. Poulose

  2. Division of General Surgery, Santa Casa of Sao Paulo Medical School, Rua Mato Grosso 306-CJ 408, Sao Paulo, 01239-040, Brazil

    S. Roll

  3. William Beaumont Hospital-Troy, 44199 Dequindre, Troy, MI, 48085-1128, USA

    J. W. Murphy

  4. Carolinas Medical Center, 1000 Blythe Blvd, 2nd Fl Administrative Suites, Charlotte, NC, 28203, USA

    B. D. Matthews

  5. Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive #300, Charlotte, NC, 28204, USA

    B. Todd Heniford

  6. Mid-South Center for Minimally Invasive Surgery, University of Tennessee Health Sciences Center, 7945 Wolf River Boulevard, Suite 200, Germantown, TN, 38138, USA

    G. Voeller

  7. New Hanover Regional Medical Center, 2131 S. 17th Street, PO Box 9025, Wilmington, NC, 28401, USA

    W. W. Hope

  8. Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA

    M. I. Goldblatt

  9. Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756-0001, USA

    G. L. Adrales

  10. The Cleveland Clinic, 9500 Euclid Avenue/A100, Cleveland, OH, 44195, USA

    M. J. Rosen

Authors
  1. B. K. Poulose
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  2. S. Roll
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  3. J. W. Murphy
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  4. B. D. Matthews
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  5. B. Todd Heniford
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  6. G. Voeller
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  7. W. W. Hope
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  8. M. I. Goldblatt
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  9. G. L. Adrales
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  10. M. J. Rosen
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Corresponding author

Correspondence to B. K. Poulose.

Ethics declarations

Institutional review board approval

The data collected for the Americas Hernia Society Quality Collaborative has been deemed as quality improvement and non-research by the Vanderbilt University Medical Center. The secondary review of these data for publication has been approved by the Vanderbilt University Medical Center Institutional Review Board.

Funding

Funding for the Americas Hernia Society Quality Collaborative is obtained through the Americas Hernia Society Foundation and the Americas Hernia Society Quality Collaborative Foundation.

Conflict of interest

The Americas Hernia Society Quality Collaborative receives funding through the Americas Hernia Society Foundation and the Americas Hernia Society Quality Collaborative Foundation. The latter entity receives funds currently from Bard-Davol, Covidien, Insightra Medical, Maquet Medical, LifeCell, TelaBIO, and Intuitive Surgical. Dr. Poulose reports personal fees from Ariste Medical (consultancy), and research grants from Bard-Davol, outside the submitted work. Dr. Murphy reports personal fees from Insightra Medical (consultancy, speaker), outside the submitted work. Dr. Matthews reports personal fees from W. L. Gore (consultancy), personal fees from Ethicon JnJ (expert witness) and reports personal fees from W. L. Gore (speaker) outside the submitted work. Dr. Heniford reports research grants and personal fees from W. L. Gore (course support, consultancy, travel), personal fees from Ethicon (consultancy), research grants and personal speaking fees (speaker) from Bard-Davol, Synovis, and LifeCell, outside the submitted work. Dr. Hope reports research grants and personal fees (consultancy) from Bard-Davol, and personal fees from eMedicine (manuscript writing honoraria), outside the submitted work. Dr. Goldblatt reports personal fees from Covidien (consultancy, lectures), research grants and personal fees from W. L. Gore (consultancy, lectures), research grants and personal fees from Bard-Davol (lectures), outside the submitted work. Dr. Rosen reports personal fees from Bard-Davol (consultancy, lectures), personal fees from LifeCell (consultancy, lectures), and research grants from W. L. Gore, outside the submitted work. Drs. Roll, Voeller, and Adrales have nothing to disclose.

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Poulose, B.K., Roll, S., Murphy, J.W. et al. Design and implementation of the Americas Hernia Society Quality Collaborative (AHSQC): improving value in hernia care. Hernia 20, 177–189 (2016). https://doi.org/10.1007/s10029-016-1477-7

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  • DOI: https://doi.org/10.1007/s10029-016-1477-7

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