Defining Quality in Surgery
With growing recognition of wide variations in surgical performance, demand for information on surgical quality is at an all time high. However, there is very little agreement about how to best assess performance in surgery. According to the widely used Donabedian paradigm, quality can be measured using various aspects of structure, process, or outcome. Recently, there is growing enthusiasm for composite (or “global”) measures of quality. In this chapter, we discuss the pros and cons of each measurement approach and make recommendations for choosing among them.
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