The next step in surgical quality improvement: outcome situational awareness

The next step in surgical quality improvement: outcome situational awareness

Can J Surg 2020;63(2):E120-E122 | PDF

William B. Lyman, MD; Michael Passeri, MD; Keith Murphy, MSPH; Allyson Cochran, MSPH; David A. Iannitti, MD; John B. Martinie, MD; Erin H. Baker, MD; Brent D. Matthews, MD; Dionisios Vrochides, MD, PhD

Summary

A similar theme unites proposed solutions for stagnant improvement in outcomes and rising health care costs: eliminate unnecessary variation in the care of surgical patients. While large quality-improvement projects like the Americal College of Surgeons National Surgical Quality Improvement Program have historically led to improved patient outcomes at the hospital level, the next step in surgical quality improvement is to eliminate unnecessary variation at the level of the individual surgeon. Critical examination of individualized clinical, financial and patient-reported outcomes — outcome situational awareness — along with peer group comparison will help surgeons to identify variation in patient care. We are piloting an interactive software platform at our institution to provide information on individualized clinical, financial and patient-reported outcomes in real time through automatic data population of a central REDCap database. These individualized data along with peer group comparison allow surgeons to objectively determine areas of potential improvement.


Posters presented at ERAS USA First Annual Meeting, Dallas, TX, Nov 10–11, 2017; and Sixth ERAS World Congress, Stockholm, Sweden, May 23–25, 2018.

Accepted June 27, 2019

Affiliations: From the Department of Surgery, Carolinas Medical Center, Charlotte, NC (Lyman, Matthews); and the Division of HPB Surgery, Carolinas Medical Center, Charlotte, NC (Passeri, Murphy, Cochran, Iannitti, Martinie, Baker, Vrochides).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication. No other competing were declared.

DOI: 10.1503/cjs.000519

Correspondence to: W.B. Lyman, Department of Surgery, Carolinas Medical Center, 1000 Blythe Blvd, MEB Suite 601, Charlotte NC 28204, william.Lyman@carolinashealthcare.org