Programmatic quality measures: a new model to promote surgical quality

Xane Peters; Jill Sage; Courtney Collins; Frank Opelka; Clifford Ko

doi:10.1093/haschl/qxad094

Programmatic quality measures: a new model to promote surgical quality

Health Aff Sch. 2024 Jan 3;2(1):qxad094. doi: 10.1093/haschl/qxad094. eCollection 2024 Jan.

Authors

Xane Peters^{1

2}, Jill Sage³, Courtney Collins⁴, Frank Opelka³, Clifford Ko^{1

5

6}

Affiliations

¹ Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL 60611, United States.
² Department of Surgery, Loyola University Medical Center, Maywood, IL 60153, United States.
³ Division of Advocacy and Health Policy, American College of Surgeons, Washington, DC 20001, United States.
⁴ Division of Gastrointestinal and General Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
⁵ University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90024, United States.
⁶ Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, United States.

Abstract

Health care performance metrics are offered predominantly in terms of outcomes, processes, or structural components of health care delivery. However, measurement is limited by variability in data sources, definitions, and workarounds. The American College of Surgeons has recently developed a new type of performance metric known as a "programmatic measure". These metrics align structures, processes, and outcomes to better coordinate quality measurement with support of frontline care teams. In this multifaceted way, these measures differ from current "single" measures such as targeting surgical site infection. The thematic focus of these measures and alignment of structure-resource components to support processes and outcomes also sets these measures apart from contemporary composite measures. Importantly, structural elements of these measures reflect minimum resources required for patient care, addressing staffing and resource barriers felt by local institutions in addressing numerous existing quality metrics. These metrics will streamline quality reporting to improve care navigation for patients. Clinicians will find more appropriately aligned goals and responsibilities, resulting in increased teamwork and communication. These measures are designed to address the current burdens of overabundant metrics, priority misalignment, and low resources in a patient-centric fashion to better align health care quality and measurement.

Keywords: programmatic measure; quality metric; surgical quality.