Key result
Strategies to improve surgical quality, such as selective referral, process compliance, and outcomes measurement, have distinct advantages and disadvantages depending on clinical and political contexts.
The optimal strategy to reduce variation in surgical mortality depends on clinical context and political realities, with selective referral, process compliance, and outcomes measurement offering distinct advantages.
Context-specific choice among surgical quality strategies may optimize outcomes; leaves open comparative trials to identify superior approaches.
Surgical mortality varies widely across hospitals and surgeons, more so than would be predicted by chance alone or differences in case mix. Although a large body of research has suggested the importance of procedure volume, clinical mechanisms underlying variation in surgical mortality remain largely unknown. Payers, policy makers, and professional organizations have implemented a variety of large-scale strategies aimed at improving outcomes. Selective referral, process compliance, and outcomes measurement reflect different philosophies on how best to improve surgical quality and have distinct advantages and disadvantages. The optimal strategy may depend on both the clinical context (e.g., which procedure) and political realities.
No takes yet. Share an insight, caveat, or question.
Birkmeyer et al. (2008) conducted a review in Surgical mortality. Strategies to improve surgical quality, such as selective referral, process compliance, and outcomes measurement, have distinct advantages and disadvantages depending on clinical and political contexts.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: