A closer look at surgical quality measures across different surgical specialties

Most studies of surgical quality improvement have been performed in large and/or teaching hospitals; the efficacy of safety and quality efforts in smaller hospitals have not been reported.

Four smaller hospitals joined a collaborative to study process measures through an expanded surgical time-out and some outcomes. The data were collected in real time.

Well-performing hospitals (all 4) improved further but variably. Gynecologic and orthopedic surgeons performed more consistently in most measures than did general surgeons.

These small hospitals readily accepted a time-out-based real-time data collection and with their surgical staff improved in most parameters.