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Quality Assessment in Surgery: Mission Impossible?

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Patient Safety in Surgery


Patients, health care providers, and payers in many countries demand a comprehensive assessment of quality in surgery. By collecting, reporting and comparing surgical outcome, deficiencies in surgical care may be unveiled and corrected to improve safety and quality in surgery. Reliable data collection is also important to compare the outcome of different treatments and for benchmarking. However, any evaluation of surgical quality remains elusive, unless there is a common methodology for reporting negative outcomes and a consensus on what good quality should be. Quality can be viewed from different angles—the definition of quality may widely differ between patients, the society, administrators, and health care policy makers. Yet, the incidence of postoperative complications is still the most frequently used surrogate marker of surgical quality but the definition of a surgical complication still lacks standardization, hampering the interpretation of surgical performance. The Clavien-Dindo classification introduced in 2004 provides a validated, easy-to-use, treatment-based classification of surgical complications that has gained wide acceptance in the surgical community. It enables an objective and standardized assessment of surgical performance—a prerequisite to improve the quality of surgical care provided to our patients.

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Correspondence to Daniel Dindo MD .

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Dindo, D., Clavien, PA. (2014). Quality Assessment in Surgery: Mission Impossible?. In: Stahel, P., Mauffrey, C. (eds) Patient Safety in Surgery. Springer, London.

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