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Surgical Endoscopy

, Volume 33, Issue 7, pp 2043–2049 | Cite as

Public reporting and transparency: a primer on public outcomes reporting

  • John R. RomanelliEmail author
  • Pascal R. Fuchshuber
  • Jonah James Stulberg
  • Rebecca Brewer Kowalski
  • Prashant Sinha
  • Thomas A. Aloia
  • Rocco OrlandoIII
SAGES Quality Outcomes and Safety Review
  • 14 Downloads

Abstract

Introduction

Healthcare consumers seeking accurate information about where to find quality surgical care face a confusing constellation of rating systems that lack transparency or consistency of opinion. For example, a 2016 report in Health Affairs demonstrated that no hospital was rated as a high performer by all four prominent national ratings systems: Consumer Reports, Leapfrog, Healthgrades and U.S. News & World Report (Austin et al. Health Aff 34:423–430, 2015). Surgeons should have an understanding of the current state of public reporting of quality; hospital ratings and data sources; physician ratings and data sources; and transparency of reporting.

Methods

We conducted a non-systematic review of the literature.

Results

Hospital quality ratings remain nebulous and there is not universal opinion on the utility of voluntary participation in ranking systems, leaving the current systems largely opinion-based. Early attempts at physician ranking systems are rudimentary at best and suffer from methodological concerns. Publicly reported metrics should be easily understandable, accessible, clinically relevant, reliable, non-punitive, and shielded from legal discovery. Transparency is increasing within institutions to help align staff to institutional objectives, while specialty specific registries are helping to standardize care pathways and outcomes measures across organizations. Measuring surgical outcomes beyond 30-day morbidity and mortality has been plagued by a lack of understanding on how to create metrics that matter; the four attributes of relevance, scientific soundness, feasibility and comprehensiveness set a high bar for the development of effective and efficient quality measures in surgery.

Discussion

SAGES, via the Quality, Outcomes, and Safety Committee, is committed to learning how to develop meaningful quality metrics in general surgery and will continue to work in other areas that impact quality, such as opioid prescribing, and surgeon wellness.

Keywords

Transparency Quality Healthcare reporting Ratings 

Notes

Acknowledgements

The authors would like to specifically acknowledge the work of Erin Schwarz of BSC Management, Inc. and the Society of American Gastrointestinal and Endoscopic Surgeons, as she helped not only to organize this manuscript, but the Committee from which this manuscript came from. The creation of this document would not have been possible without her invaluable assistance.

Compliance of ethical standards

Disclosures

Dr. Stulberg reports consulting with Intuitive Surgical and funded research by National Institutes of Health and Pacira Pharmaceuticals, none of which was relevant to the creation of this manuscript. Drs. Romanelli, Fuchshuber, Kowalski, Sinha, Aloia, and Orlando have no conflicts of interest or financial ties to disclose.

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Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons 2019

Authors and Affiliations

  1. 1.Department of SurgeryBaystate Medical CenterSpringfieldUSA
  2. 2.Kaiser PermanenteWalnut CreekUSA
  3. 3.Northwestern Memorial HospitalChicagoUSA
  4. 4.Lenox Hill HospitalNew YorkUSA
  5. 5.NYU Langone Medical CenterNew YorkUSA
  6. 6.The University of Texas MD Anderson Cancer CenterHoustonUSA
  7. 7.Hartford HealthcareHartfordUSA

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