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The next step in surgical quality improvement: outcome situational awareness
William B. Lyman1, Michael Passeri1, Keith Murphy1
1From 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).
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.
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