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Surgical Quality Measurement An Evolving Science

Ryan P. Merkow, MD, MS1,2,3; Karl Y. Bilimoria, MD, MS1,2; Clifford Y. Ko, MD, MS, MSHS1,4
[+] Author Affiliations
1Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, Illinois
2Department of Surgery, Surgical Outcomes and Quality Improvement Center, and the Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
3Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois
4Department of Surgery, University of California at Los Angeles and VA Greater Los Angeles Healthcare System, Los Angeles, California
JAMA Surg. 2013;148(7):586-587. doi:10.1001/jamasurg.2013.128.
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Approximately 48 million inpatient procedures are performed in the United States annually.1 As the population ages, the use of minimally invasive techniques becomes more widespread, and surgical indications expand, the annual number of procedures performed is expected to drastically increase. Poor surgical care results in substantial harm to individual patients and has dramatic effects on health care costs. For example, the occurrence of a postoperative complication can result in a 5-fold increase in cost compared with the same procedure without a complication.2 Therefore, it is not surprising that in recent years a growing national interest in surgical quality measurement and improvement has occurred. Nevertheless, past and present initiatives have generally measured surgical quality in fragmented silos that may not reflect true surgical quality. Although current methods evaluating surgical quality have relevance, perhaps alternative strategies are necessary to engender more meaningful improvements in surgical care.

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