Abstract
Patients, health care providers, and payers in many countries demand a comprehensive assessment of quality in surgery. By collecting, reporting and comparing surgical outcome, deficiencies in surgical care may be unveiled and corrected to improve safety and quality in surgery. Reliable data collection is also important to compare the outcome of different treatments and for benchmarking. However, any evaluation of surgical quality remains elusive, unless there is a common methodology for reporting negative outcomes and a consensus on what good quality should be. Quality can be viewed from different angles—the definition of quality may widely differ between patients, the society, administrators, and health care policy makers. Yet, the incidence of postoperative complications is still the most frequently used surrogate marker of surgical quality but the definition of a surgical complication still lacks standardization, hampering the interpretation of surgical performance. The Clavien-Dindo classification introduced in 2004 provides a validated, easy-to-use, treatment-based classification of surgical complications that has gained wide acceptance in the surgical community. It enables an objective and standardized assessment of surgical performance—a prerequisite to improve the quality of surgical care provided to our patients.
Highlights
Quality in Surgery Safety and quality have become prominent criteria by which surgical care is evaluated
In 2004, we proposed a classification system for surgical complications, which has gained much acceptance in the surgical community with over 400 citations [2,3]
E.g. in Sweden, the registration of complications according to this classification system has even becomes mandatory in upper-GI surgery.)
Summary
Quality in Surgery Safety and quality have become prominent criteria by which surgical care is evaluated. Quality assessment in surgery requires different components in order to be valuable. There is still no common sense on how to report surgical outcome. Another key task in assessing the quality of surgery is to take into account the degree of risk of the patients studied.
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