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Value-Based Clinical Quality Improvement for Chronic Groin Pain After Inguinal Hernia Repair

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The SAGES Manual of Groin Pain

Abstract

Chronic pain after hernia repair is an extremely complex problem. When complex problems exist in healthcare, there will be no one specific cause producing the outcomes. Multiple factors combine to produce a variety of outcomes for different patient subpopulations. Traditional reductionist, science-based clinical research tools will not be adequate to improve value-based outcomes. Complex systems science and tools such as value-based clinical quality improvement (CQI) and nonlinear statistical analytics do have the potential to help provide better outcomes for patients suffering from complex medical problems such as chronic pain after hernia repair. This chapter will describe the principles and methods for designing a CQI program for the management of patients with chronic pain after hernia repair. The discussion will describe some of the potential benefits of applying CQI for this patient group and the benefits that could occur if multiple collaborative CQI programs were implemented to improve the lives of patients with this condition.

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References

  1. Bohmer RM. Designing care: aligning the nature and management of health care. Boston, MA: Harvard Business Press; 2009.

    Google Scholar 

  2. Porter ME, Lee TH. The strategy that will fix health care. Harv Bus Rev. 2013;91(10):50–70.

    Google Scholar 

  3. Kaplan RS, Porter ME. How to solve the health care cost crisis. Harv Bus Rev. 2011;89(9):46–52. 54, 56–61 passim.

    PubMed  Google Scholar 

  4. Ramshaw B. Establishing a hernia program and follow-up regimen: a complex systems design for care and improvement. In: Jacob BP, Ramshaw B, editors. The SAGES manual of hernia repair. New York: Springer; 2013. p. 3–18.

    Chapter  Google Scholar 

  5. Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society–IEHS)-part 1. Surg Endosc. 2014;28(1):2–29.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Elhauge E. The fragmentation of the U.S. health care: causes and solutions. New York: Oxford University Press; 2010.

    Book  Google Scholar 

  7. Cebul RD, Rebitzer JB, Taylor LJ, Vortruba ME. Organization fragmentation and care quality in the U.S. healthcare system. J Econ Perspect. 2008;22(4):93–113.

    Article  PubMed  Google Scholar 

  8. Hunt R, Newman R. Medical knowledge overload: a disturbing trend for physicians. Health Care Manag Rev. 1997;22(1):70–5.

    CAS  Google Scholar 

  9. Zimmerman B, Lindberg C, Plsek P. Edgeware: insights from complexity science for health care leaders. Irving, TX: VHA; 1998.

    Google Scholar 

  10. Bizzarro MJ, Sabo B, Noonan M, Bonfiglio MP, Northrup V, Diefenbach K, Central Venous Catheter Initiative Committee. A quality improvement initiative to reduce central line-associated bloodstream infections in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 2010;13(3):241–8.

    Article  Google Scholar 

  11. Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education and research. Washington, DC: The National Academies Press; 2011.

    Google Scholar 

  12. Macintyre PE, Schug SA, Scott DA, Visser EJ, Walker SM, APMSE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Acute pain management: scientific evidence. 3rd ed. Melbourne: ANZCA & FPM; 2010.

    Google Scholar 

  13. U.S. Department of Health & Human Services. Frequently asked questions about human research. 2015. http://answers.hhs.gov/ohrp/categories/1569. Accessed 20 Apr 2015

  14. Mayer-Schönberger V, Cukier K. Big data: a revolution that will transform how we live, work and think. London: John Murray; 2013.

    Google Scholar 

  15. Siegel E. Predictive analytics: the power to predict who will click, buy, lie, or die. Hoboken, NJ: Wiley; 2013.

    Google Scholar 

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Correspondence to Bruce Ramshaw MD, FACS .

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© 2016 Springer International Publishing Switzerland

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Ramshaw, B. (2016). Value-Based Clinical Quality Improvement for Chronic Groin Pain After Inguinal Hernia Repair. In: Jacob, B., Chen, D., Ramshaw, B., Towfigh, S. (eds) The SAGES Manual of Groin Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-21587-7_45

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  • DOI: https://doi.org/10.1007/978-3-319-21587-7_45

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21586-0

  • Online ISBN: 978-3-319-21587-7

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