Evaluating Patient-Centered Surgical Care Quality Using Patient-Reported Measures of Shared Decision-Making.

Area of Science:

• Healthcare Quality
• Surgical Care
• Patient-Reported Outcomes

Background:

• Shared decision-making (SDM) is crucial in surgical care but lacks patient-perspective performance measures.
• Evaluating SDM quality from patient viewpoints is essential for improving care standards.

Purpose of the Study:

• To assess if SDM levels can be differentiated among hospitals and surgeons.
• To determine the feasibility of implementing SDM as a performance measure by estimating required sample sizes for statistical reliability.

Main Methods:

• Two patient-reported SDM measures, CollaboRATE and SDM-Q-9, were used.
• 24 candidate performance measures were developed for hospital and surgeon levels.
• Mixed models analyzed statistical reliability and projected minimum sample sizes, exploring risk adjustment and nonresponse bias.

Main Results:

• CollaboRATE demonstrated higher reliability (0.81 median) for hospitals, requiring 192-235 responses.
• CollaboRATE also showed higher reliability (0.49 median) for surgeons, needing only 46 responses.
• Performance differences in SDM were distinguishable at both hospital and surgeon levels.

Conclusions:

• CollaboRATE reliably distinguishes patient-centered care quality at hospital and surgeon levels.
• Implementing CollaboRATE as a surgeon-specific performance measure is feasible due to low response number requirements.
• This study supports the use of patient-reported measures for evaluating SDM in surgical settings.