Process Measures in Quality: MBSAQIP

Abstract

In the last decade, the need for transparency in improving quality and patient safety outcomes has grown tremendously across the nation. However, in most recent years since the Institute of Medicine (IOM) published “To Err Is Human and Crossing the Quality Chasm” to shine a light on quality and patient safety as measurements of care, many healthcare organizations promote improvement in specific outcome metrics and provide ongoing monitoring of clinical outcomes. Obtaining quality outcomes relies heavily on the use of evidence-based research and best practice models of care. Specific quality measures are used to assess surgical quality, and the mechanisms that account for variation in care should be understood. In the late 1980s, Donabedian created a conceptual framework for assessing surgical quality. The key components of this model are structure, process of care, and outcomes used by many healthcare institutions and programs to understand the requirements, monitor, and evaluate institutional progress throughout the process. For example, in efforts to demonstrate improvement in clinical outcomes in bariatric surgery and decrease variation in care and management of the metabolic and bariatric surgery patients, the American Society Metabolic and Bariatric Surgery (ASMBS) in conjunction with the American College of Surgeons (ACS) developed quality indicators from evidence-based research, consensus guidelines, and experts’ opinion to assess and improve program outcomes in bariatric surgery. Collaboratively, the societies developed Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) as a platform for assessing quality in bariatric surgery. In the MBSAQIP data registry, distinct metrics are identified that must be met or exceeded indicating high-quality outcomes. The principles of Donabedian conceptual framework are sound and reliable and are used in this chapter as scientific evidence guiding the processes of care measures to MBSAQIP accreditation.