Performance measurement in surgery through the National Quality Forum.

Autor:	Hyder JA; Department of Anesthesiology, Division of Respiratory and Critical Care Medicine, Mayo Clinic, Rochester, MN; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA. Electronic address: hyder.joseph@mayo.edu., Roy N; Department of Surgery Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA., Wakeam E; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA; Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada., Hernandez R; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA; Department of Surgery, Brigham and Women's Hospital, Boston, MA., Kim SP; Department of Urology, Yale Medical School, New Haven, CT., Bader AM; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA; Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada., Cima RR; Department of Surgery, Mayo Clinic, Rochester, MN; Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN., Nguyen LL; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA; Department of Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Surgeons [J Am Coll Surg] 2014 Nov; Vol. 219 (5), pp. 1037-46. Date of Electronic Publication: 2014 Jul 05.
DOI:	10.1016/j.jamcollsurg.2014.06.018
Abstrakt:	Background: Performance measurement has become central to surgical practice. We systematically reviewed all endorsed performance measures from the National Quality Forum, the national clearing house for performance measures in health care, to identify measures relevant to surgical practice and describe measure stewardship, measure types, and identify gaps in measurement. Study Design: Performance measures current to June 2014 were categorized by denominator statement as either assessing surgical practice in specific or as part of a mixed medical and surgical population. Measures were further classified by surgical specialty, Donabedian measure type, patients, disease and events targeted, reporting eligibility, and measure stewards. Results: Of 637 measures, 123 measures assessed surgical performance in specific and 123 assessed surgical performance in aggregate. Physician societies (51 of 123, 41.5%) were more common than government agencies (32 of 123, 26.0%) among measure stewards for surgical measures, in particular, the Society for Thoracic Surgery (n = 32). Outcomes measures rather than process measures were common among surgical measures (62 of 123, 50.4%) compared with aggregate medical/surgical measures (46 of 123, 37.4%). Among outcomes measures, death alone was the most commonly specified outcome (24 of 62, 38.7%). Only 1 surgical measure addressed patient-centered care and only 1 measure addressed hospital readmission. We found 7 current surgical measures eligible for value-based purchasing. Conclusions: Surgical society stewards and outcomes measure types, particularly for cardiac surgery, were well represented in the National Quality Forum. Measures addressing patient-centered outcomes and the value of surgical decision-making were not well represented and may be suitable targets for measure innovation. (Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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