Identifying critical quality metrics in Mohs Surgery: A national expert consensus process.

Autor: Dodson JA; Rush Medical College of Rush University Medical Center, Chicago, Illinois., Ibrahim SA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois., Rogers H; President, American College of Mohs Surgery, CMO, Advanced Dermatology, Norwich, Connecticut., Council ML; Division of Dermatology, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri., Nehal KS; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York., Tung R; Florida Dermatology and Skin Cancer Centers, Winter Haven, Florida., Leffell DJ; Department of Dermatology, Yale School of Medicine, New Haven, Connecticut., Zeitouni NC; Division of Dermatology, Department of Internal Medicine, University of Arizona, Phoenix, Arizona., Totonchy MB; Skin Surgery Center, Seattle, Washington., Fosko SW; Department of Dermatology, University of Florida, Gainesville, Florida., Lee Soon S; The Skin Clinic MD, San Diego, California., Blalock TW; Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia., Brodland DG; Z & B Skin Cancer Center, Pittsburgh, Pennsylvania., Billingsley EM; Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania., Scott JF; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Leach BC; The Skin Surgery Center of Charleston, Mount Pleasant, South Carolina., Ratner D; Dermatology, NYU Grossman School of Medicine, New York, New York., Washington C; Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Partner; Dermatology Associates of Georgia, Decatur, Georgia., Hanke CW; Laser and Skin Surgery Center of Indiana, Indianapolis, Indiana; Program Director, ACGME Micrographic Surgery/Dermatologic Oncology Fellowship Training Program, Ascension St. Vincent Hospital, Indianapolis, Indiana; Department of Dermatology, University of Iowa-Carver College of Medicine, Iowa City, Iowa., Otley CC; Department of Dermatology, Mayo Clinic, Rochester, Minnesota., Golda N; Dermatology and Skin Cancer Centers, Kansas City, Missouri., Nijhawan RI; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas., Brewer J; Department of Dermatology, Mayo Clinic, Rochester, Minnesota., Demer A; Department of Dermatology, Mayo Clinic, Rochester, Minnesota., Fish F; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota., Harmon CB; Advanced Dermatology, Norwich, Connecticut., Zitelli J; Department of Dermatology, Otolaryngology, and Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Knackstedt T; Mohs Surgery Unit, Pinehurst Dermatology & Mohs Surgery Center, Pinehurst, North Carolina; Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, Ohio., Singh G; Forefront Dermatology, Wauwatosa, Wisconsin., Mollet T; Department of Dermatology, Skin Surgery Center of Oklahoma, Oklahoma City, Oklahoma., Carr DR; Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio., Albertini JG; The Skin Surgery Center, Winston-Salem, North Carolina., Moody BR; Heritage Medical Associates, Nashville, Tennessee., McDonald M; Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio., Bordeaux JS; Department of Dermatology, Warren Alpert Medical School at Brown University, Worcester, Massachusetts., Massey PR; Cheyenne Skin Clinic, Cheyenne, Wyoming., MacCormack MA; Foundation Skin Surgery - Solution Health, Nashua, New Hampshire., Vidimos A; Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio., Arpey CJ; Department of Dermatology, Mayo Clinic, Scottsdale, Arizona., Arron ST; Peninsula Dermatology, Burlingame, California., Ibrahimi OA; Department of Dermatology, Connecticut Skin Institute, Stamford, Connecticut., Jiang SB; University of California, San Diego, California., Miller CJ; Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania., Maher IA; Advanced Dermatology, Norwich, Connecticut., Wysong A; Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska., Leshin B; Department of Dermatology, Skin Surgery Center, Winston-Salem, North Carolina., Goldman GD; University of Vermont Medical Center, Burlington, Vermont., Kibbi N; Department of Dermatology, Stanford University School of Medicine, Redwood City, California., Feng H; Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: haofeng625@gmail.com., Collins L; Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2024 Apr; Vol. 90 (4), pp. 798-805. Date of Electronic Publication: 2023 Dec 09.
DOI: 10.1016/j.jaad.2023.10.069
Abstrakt: Background: Amid a movement toward value-based healthcare, increasing emphasis has been placed on outcomes and cost of medical services. To define and demonstrate the quality of services provided by Mohs surgeons, it is important to identify and understand the key aspects of Mohs micrographic surgery (MMS) that contribute to excellence in patient care.
Objective: The purpose of this study is to develop and identify a comprehensive list of metrics in an initial effort to define excellence in MMS.
Methods: Mohs surgeons participated in a modified Delphi process to reach a consensus on a list of metrics. Patients were administered surveys to gather patient perspectives.
Results: Twenty-four of the original 66 metrics met final inclusion criteria. Broad support for the initiative was obtained through physician feedback.
Limitations: Limitations of this study include attrition bias across survey rounds and participation at the consensus meeting. Furthermore, the list of metrics is based on expert consensus instead of quality evidence-based outcomes.
Conclusion: With the goal of identifying metrics that demonstrate excellence in performance of MMS, this initial effort has shown that Mohs surgeons and patients have unique perspectives and can be engaged in a data-driven approach to help define excellence in the field of MMS.
Competing Interests: Conflicts of interest None disclosed.
(Copyright © 2023 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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