Comparing surgeon perception to publicly reported data using NSQIP.

Area of Science:

• Surgical Quality Improvement
• Patient Outcomes Research
• Medical Education

Background:

• Surgeons' self-assessment of postoperative complication rates may be inaccurate.
• The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database provides validated metrics for surgical quality.
• Understanding this discrepancy is crucial for improving surgical care standards.

Purpose of the Study:

• To compare surgeons' perceived postoperative complication rates with objective data from the NSQIP database.
• To investigate whether surgeons accurately estimate their individual rates of morbidity, readmission, and reoperation.
• To assess surgeons' accuracy in estimating complication rates relative to their peers.

Main Methods:

• Surveys collected data on perceived rates of morbidity, readmission, and reoperation.
• Respondents compared their rates to their peers and institutional NSQIP data.
• Data from a large level one trauma center was analyzed.

Main Results:

• A significant majority of surgeons underestimated their individual rates: 87.5% for morbidity, 35.4% for readmission, and 22.9% for reoperation.
• Surgeons demonstrated higher accuracy when estimating rates relative to their department: 57.78% for morbidity, 75.56% for readmission, and 86.67% for reoperation.
• These findings highlight a notable gap between perceived and actual individual surgical outcomes.

Conclusions:

• Surgeons are generally poor predictors of their own 30-day postoperative complication rates.
• Self-assessment accuracy improves when surgeons compare their performance to departmental averages.
• This suggests a need for enhanced feedback mechanisms and potentially improved surgical education on outcome prediction.