Defining and Measuring Quality

Abstract

Defining and measuring quality in metabolic and bariatric surgery is critical so we can provide the high quality of care we and our patients want. Furthermore, the field of metabolic and bariatric surgery has been scrutinized by policymakers and the press, making it imperative that we can demonstrate that surgery can be performed safely at accredited centers. Quality is complex but can be best summed up by the Institutes of Medicine’s description as being safe, effective, patient centered, timely, efficient, and equitable. Quality can be measured according to the Donabedian framework by assessing structure, processes, or outcomes. The key to measuring quality is high-quality data. The MBSAQIP data collection program collects high-quality data that is risk-adjusted, prospective, and clinically rich data collected by third party data collectors based on standardized definitions and processes. Surgeons should be leaders in quality assessment – if we don’t define quality, then others will do so and do so badly, and we and our patients will be stuck with the consequences.