Quality Indicators in Head and Neck Operations<subtitle>A Comparison With Published Benchmarks</subtitle>

Abstract

Our findings demonstrate the applicability of quality indicators to the care of patients with head and neck cancer treated by surgical intervention stratified by acuity and compared with established benchmarks.

Quality assessment in head and neck oncologic surgery in a Brazilian cancer center compared with MD Anderson Cancer Center benchmarks

“…Patients with relevant comorbid conditions also had a significantly higher incidence of negative outcome indicators, as well patients classified as ASA class III or IV when compared with those in class I or II. These findings, together with similar data from previously published reports, highlight the need for patient stratification based on the comorbidities for quality assessment and the importance of routine intensive preoperative clinical evaluations, predicting negative outcomes and providing risk stratification for patient's postoperative course.…”

“…In head and neck surgery, MD Anderson is a pioneer in quality assessment, with several articles addressing this matter published since 2007 . The American Head and Neck Society provided quality metrics for oral and laryngeal cancer surgery; however, the other head and neck subsites still lack specific benchmarks for quality assessment.…”

“…Performance indicators were very similar for LAPs and HAPs, except for cutoff points in length of hospital stay (3 days for LAPs and 12 days for HAPs) and transfusion (1 unit of packed red blood cells for LAPs and 2 for HAPs). For analysis, including both LAPs and HAPs or to show the impact of surgical acuity in the outcome, we used a cutoff for length of hospital stay of 6 days, based on published MD Anderson data and benchmarks . Negative performance indicators were considered when transfusion or length of hospital stay exceeded the cutoff points or surgical site infection, return to operating room, readmission, or mortality occurred.…”

Surgical site infections in paediatric otolaryngology operative procedures

“…Although in our study neither of the two BAHA cases developed an SSI. The rate of SSIs within a healthcare facility has now been deemed an indicator for the measurement of quality of care provision, this emphasises the need to establish formal regimes for the monitoring and collecting data on SSIs [20][21][22]. Not only must SSIs be treated appropriately in a timely fashion, but the data for each case must be accurately captured and recorded.…”

Quality Indicators for Head and Neck Oncologic Surgery

“…MD Anderson recently proposed LOS, readmission rate, return to the OR, 30-day mortality, use of blood products, adequacy of pathologic reports, and surgical site infection as validated quality indicators for HNCA surgery. 6 However, to date, application of these specific quality indicators has been limited to singleinstitution academic centers. 5,7 We sought to utilize described HNCA quality indicators to determine if there are differences in the quality of care at academic teaching hospitals versus nonacademic centers.…”