The following three sets of measures are proposed to measure surgical quality:
1. Adverse Events: The first measure would be the percentage frequency of the following adverse events.
a. Unplanned return to surgery
b. Complications
c. Admissions/Readmissions during the global period
d. ED visits in the global period
2. Variation from the Plan of Care: The second measure would require a global plan of care for each patient undergoing surgery. The global period would be the day of care plus 90-days for inpatient and the day of care plus 10 days for outpatient. The quality measure would be the average percentage variation between the planned care costs and the costs of the actual services provided. Each year the composite variation in actual to planned costs would be a performance measure reported for every surgeon.
3. Voice of the customer: The final set of competitive measures would come from the results of a simple patient survey conducted at the end of the episode of care. This survey would involve three simple questions with the sole purpose of identifying overall performance. The three questions will obtain patient feedback on how well the physician and healthcare team did in meeting the expectations set in the plan of care. The patient satisfaction survey should include a five-point response ranging from did not meet to exceeded expectations. Feedback would be obtained in the following three areas:
a. Service – Responsiveness, courtesy and respect, access and wait times
b. Quality – Achieving the objectives established in the plan of care
Surgery: Recovery time, Level of recovery, duration and level of pain
c. Costs – Costs include total episode of care costs and the patient’s portion of the costs.
