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Quality Metrics in Hand Surgery: A Systematic Review
Shannon M Wood1, You J Kim1, Anne V Seyferth2
1Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI.
The Journal of Hand Surgery
|July 17, 2021
Summary
Quality measurement in hand surgery is evolving. While outcomes are key, incorporating structure and process metrics offers a more comprehensive assessment of care quality.
Area of Science:
- Orthopedic Surgery
- Health Services Research
- Quality Improvement
Background:
- The Patient Protection and Affordable Care Act (2010) emphasized healthcare quality measurement.
- Traditional quality metrics like mortality rates are insufficient for hand surgery.
- Assessing hand surgery quality requires a broader range of metrics.
Purpose of the Study:
- To review quality metrics in hand surgery literature post-Affordable Care Act.
- To identify current trends in hand surgery quality measurement.
- To guide improvements in hand surgery quality assessment.
Main Methods:
- Searched PubMed and EMBASE for hand surgery research articles.
- Extracted study characteristics, quality metrics, and quality domains.
- Analyzed 63 relevant articles from 7,308 initial results.
Main Results:
- Outcome measures were most common (100%), structure measures least common (30.2%).
- Pain and patient-reported outcomes were frequent metrics.
- Effectiveness was the most assessed quality domain; efficiency was least studied.
Conclusions:
- Significant variation exists in hand surgery quality metrics.
- Structure and process measures are crucial for a holistic quality assessment.
- Integrating structure and process metrics can enhance understanding and development of quality measures.
