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Published on: October 16, 2013
Identification of consensus-based quality end points for colorectal surgery.
Mark L Manwaring1, Clifford Y Ko, James W Fleshman
1University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.
Diseases of the Colon and Rectum
|April 4, 2012
Summary
This study developed 89 consensus-based quality measures for colorectal surgery using the modified Delphi method. These endpoints will guide surgeon registries and quality improvement initiatives in colon and rectal surgery.
Area of Science:
- Colorectal Surgery
- Surgical Quality Improvement
- Health Services Research
Background:
- Process and outcome measures for assessing colorectal surgical care quality are not well-defined.
- Standardized metrics are needed for surgeon-specific registries and quality improvement programs.
Purpose of the Study:
- To develop candidate endpoints for surgeon-specific registries.
- To establish a framework for quality improvement program development in colorectal surgery.
Main Methods:
- Modified Delphi methodology was employed to achieve consensus on quality endpoints.
- Expert panels from the American Society of Colon and Rectal Surgeons and the American Board of Colon and Rectal Surgery identified and rated measures.
- The study focused on six key areas: colectomy, rectal cancer, hemorrhoidectomy, anal fistula/abscess, colonoscopy, and rectal prolapse.
Main Results:
- Eighty-nine process and outcome measures were compiled and rated by expert consensus.
- Ranked mean scores ranged from 1.3 (anal fistula/abscess, preoperative imaging) to 4.0 (colectomy-anastomotic leak).
Conclusions:
- A consensus-derived list of 89 process and outcome measures was developed for six key areas of colorectal surgery.
- These measures provide a foundation for developing guideline standards for case-reporting and quality improvement in colon and rectal surgery.
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