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Quality indicators in head and neck operations: a comparison with published benchmarks
Thomas D Shellenberger1, Rafael Madero-Visbal, Randal S Weber
1Head and Neck Surgical Oncology, MD Anderson Cancer Center Orlando, 1400 S Orange Ave, Orlando, FL 32806, USA. thomas.shellenberger@orlandohealth.com
Objective:
To investigate the reproducibility of quality indicators in the care of patients undergoing operations for head and neck cancer.
Design:
A review of specialty-specific surgical quality indicators in a cohort undergoing procedures for definitive treatment of head and neck cancer, stratified by high and low acuity of the surgical procedures and compared with established benchmarks.
Setting:
A large tertiary care institution and an associated multidisciplinary cancer center.
Patients:
Fifty randomly selected patients with evaluable data who were diagnosed as having head and neck cancer that was definitively treated using any of the 3 modalities (surgical procedures, chemotherapy, and/or radiotherapy) during a 15-month period at our center. Twenty-one patients who underwent operations form the basis of this report.
Main Outcome Measures:
Procedures were stratified by acuity on the basis of the extent of the operation. Data were centered on quality indicators designed to reflect length of stay, readmission within 30 days postoperatively, return to the operating room within 7 days of surgery, use of blood products, 30-day mortality, adequacy of reports on surgical pathologic findings, and surgical site infection.
Results:
Diagnoses in the cohort included carcinoma of the oral cavity in 19 patients (39%), oropharynx in 14 (29%), larynx in 13 (27%), and hypopharynx in 3 (6%). High- and low-acuity surgical procedures were performed in 12 and 7 patients, respectively. No statistically significant differences in the measures for quality indicators were found between the cohort and the calculated benchmarks.
Conclusion:
Our findings demonstrate the applicability of quality indicators to the care of patients with head and neck cancer treated by surgical intervention stratified by acuity and compared with established benchmarks.
