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Embarking on improvement cycles - the next steps in surgical benchmarking
Michaela Ramser1, Fariba Abbassi2, Matthias Pfister3
1Department of Visceral Surgery and Transplantation, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland.
Langenbeck'S Archives of Surgery
|October 10, 2025
Summary
A new methodology standardizes surgical outcome comparison with benchmarks to guide quality improvement. This approach identifies care gaps, like ileostomy complications, and drives targeted interventions for better patient results.
Area of Science:
- Surgical Quality Improvement
- Health Services Research
- Clinical Benchmarking
Background:
- Established surgical benchmarks exist but lack standardized application in clinical practice.
- Current quality management processes are limited by the absence of a direct methodology for comparing outcomes to benchmarks.
- This gap hinders routine quality improvement and continuous process enhancement in surgery.
Purpose of the Study:
- To develop a standardized, clinically applicable methodology for comparing surgical outcomes against established benchmark cut-offs.
- To guide structured quality improvement initiatives within surgical departments.
- To facilitate the identification of areas for improvement by comparing clinical outcomes with defined performance thresholds.
Main Methods:
- Developed a structured quality improvement cycle comparing institutional data with surgical benchmark cut-offs.
- Incorporated periodic outcome comparison, root cause analysis for deviations, and targeted intervention implementation.
- Applied the method to 98 low anterior resection patients (2018-2023), analyzing outcomes over 18-month rolling windows.
Main Results:
- Identified deviations from benchmark targets, particularly in readmission rates linked to ileostomy complications.
- Root cause analysis pinpointed deficiencies in postoperative care and patient education.
- Implemented targeted interventions including multimedia ostomy education, enhanced nutrition, and structured outpatient support.
Conclusions:
- The developed methodology enables effective comparison of surgical outcomes with benchmarks for structured quality improvement.
- It empowers surgical teams to pinpoint outcome discrepancies, implement data-driven interventions, and promote continuous quality enhancement.
- This adaptable framework supports evidence-based surgical excellence across various procedures with existing benchmarks.
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