Defining Quality Indicators for Breast Device Surgery: Using Registries for Global Benchmarking

Husna Begum, Swarna Vishwanath, Michelle Merenda, Mark Tacey, Nicola Dean, Elisabeth Elder, Marc Mureau, Ron Bezic, Pamela Carter, Rodney D. Cooter, Anand Deva, Arul Earnest, Michael Higgs, Howard Klein, Mark Magnusson, Colin Moore, Hinne Rakhorst, Christobel Saunders, Birgit Stark, Ingrid Hopper

Research output: Contribution to journalArticle

Abstract

Background: Breast device registries monitor devices encompassing breast implants, tissue expanders and dermal matrices, and the quality of care and patient outcomes for breast device surgery. Defining a standard set of quality indicators and risk adjustment factors will enable consistency and adjustment for case-mix in benchmarking quality of care across breast implant registries. This study aimed to develop a set of quality indicators to enable assessment and reporting of quality of care for breast device surgery which can be applied globally.

Methods: A scoping literature review was undertaken, and potential quality indicators were identified. Consensus on the final list of quality indicators was obtained using a modified Delphi approach. This process involved a series of online surveys, and teleconferences over 6 months. The Delphi panel included participants from various countries and representation from surgical specialty groups including breast and general surgeons, plastic and reconstructive surgeons, cosmetic surgeons, a breast-care nurse, a consumer, a devices regulator (Therapeutic Goods Administration), and a biostatistician. A total of 12 candidate indicators were proposed: Intraoperative antibiotic wash, intraoperative antiseptic wash, preoperative antibiotics, nipple shields, surgical plane, volume of implant, funnels, immediate versus delayed reconstruction, time to revision, reoperation due to complications, patient satisfaction, and volume of activity.

Results: Three of the 12 proposed indicators were endorsed by the panel: preoperative intravenous antibiotics, reoperation due to complication, and patient reported outcome measures.

Conclusion: The 3 endorsed quality indicator measures will enable breast device registries to standardize benchmarking of care internationally for patients undergoing breast device surgery.

Original languageEnglish
Article number2348
Number of pages9
JournalPlastic and Reconstructive Surgery – Global Open
Volume7
Issue number8
DOIs
Publication statusPublished - Aug 2019

Cite this

Begum, Husna ; Vishwanath, Swarna ; Merenda, Michelle ; Tacey, Mark ; Dean, Nicola ; Elder, Elisabeth ; Mureau, Marc ; Bezic, Ron ; Carter, Pamela ; Cooter, Rodney D. ; Deva, Anand ; Earnest, Arul ; Higgs, Michael ; Klein, Howard ; Magnusson, Mark ; Moore, Colin ; Rakhorst, Hinne ; Saunders, Christobel ; Stark, Birgit ; Hopper, Ingrid. / Defining Quality Indicators for Breast Device Surgery : Using Registries for Global Benchmarking. In: Plastic and Reconstructive Surgery – Global Open. 2019 ; Vol. 7, No. 8.
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abstract = "Background: Breast device registries monitor devices encompassing breast implants, tissue expanders and dermal matrices, and the quality of care and patient outcomes for breast device surgery. Defining a standard set of quality indicators and risk adjustment factors will enable consistency and adjustment for case-mix in benchmarking quality of care across breast implant registries. This study aimed to develop a set of quality indicators to enable assessment and reporting of quality of care for breast device surgery which can be applied globally.Methods: A scoping literature review was undertaken, and potential quality indicators were identified. Consensus on the final list of quality indicators was obtained using a modified Delphi approach. This process involved a series of online surveys, and teleconferences over 6 months. The Delphi panel included participants from various countries and representation from surgical specialty groups including breast and general surgeons, plastic and reconstructive surgeons, cosmetic surgeons, a breast-care nurse, a consumer, a devices regulator (Therapeutic Goods Administration), and a biostatistician. A total of 12 candidate indicators were proposed: Intraoperative antibiotic wash, intraoperative antiseptic wash, preoperative antibiotics, nipple shields, surgical plane, volume of implant, funnels, immediate versus delayed reconstruction, time to revision, reoperation due to complications, patient satisfaction, and volume of activity.Results: Three of the 12 proposed indicators were endorsed by the panel: preoperative intravenous antibiotics, reoperation due to complication, and patient reported outcome measures.Conclusion: The 3 endorsed quality indicator measures will enable breast device registries to standardize benchmarking of care internationally for patients undergoing breast device surgery.",
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author = "Husna Begum and Swarna Vishwanath and Michelle Merenda and Mark Tacey and Nicola Dean and Elisabeth Elder and Marc Mureau and Ron Bezic and Pamela Carter and Cooter, {Rodney D.} and Anand Deva and Arul Earnest and Michael Higgs and Howard Klein and Mark Magnusson and Colin Moore and Hinne Rakhorst and Christobel Saunders and Birgit Stark and Ingrid Hopper",
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Begum, H, Vishwanath, S, Merenda, M, Tacey, M, Dean, N, Elder, E, Mureau, M, Bezic, R, Carter, P, Cooter, RD, Deva, A, Earnest, A, Higgs, M, Klein, H, Magnusson, M, Moore, C, Rakhorst, H, Saunders, C, Stark, B & Hopper, I 2019, 'Defining Quality Indicators for Breast Device Surgery: Using Registries for Global Benchmarking' Plastic and Reconstructive Surgery – Global Open, vol. 7, no. 8, 2348. https://doi.org/10.1097/GOX.0000000000002348

Defining Quality Indicators for Breast Device Surgery : Using Registries for Global Benchmarking. / Begum, Husna; Vishwanath, Swarna; Merenda, Michelle; Tacey, Mark; Dean, Nicola; Elder, Elisabeth; Mureau, Marc; Bezic, Ron; Carter, Pamela; Cooter, Rodney D.; Deva, Anand; Earnest, Arul; Higgs, Michael; Klein, Howard; Magnusson, Mark; Moore, Colin; Rakhorst, Hinne; Saunders, Christobel; Stark, Birgit; Hopper, Ingrid.

In: Plastic and Reconstructive Surgery – Global Open, Vol. 7, No. 8, 2348, 08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Defining Quality Indicators for Breast Device Surgery

T2 - Using Registries for Global Benchmarking

AU - Begum, Husna

AU - Vishwanath, Swarna

AU - Merenda, Michelle

AU - Tacey, Mark

AU - Dean, Nicola

AU - Elder, Elisabeth

AU - Mureau, Marc

AU - Bezic, Ron

AU - Carter, Pamela

AU - Cooter, Rodney D.

AU - Deva, Anand

AU - Earnest, Arul

AU - Higgs, Michael

AU - Klein, Howard

AU - Magnusson, Mark

AU - Moore, Colin

AU - Rakhorst, Hinne

AU - Saunders, Christobel

AU - Stark, Birgit

AU - Hopper, Ingrid

PY - 2019/8

Y1 - 2019/8

N2 - Background: Breast device registries monitor devices encompassing breast implants, tissue expanders and dermal matrices, and the quality of care and patient outcomes for breast device surgery. Defining a standard set of quality indicators and risk adjustment factors will enable consistency and adjustment for case-mix in benchmarking quality of care across breast implant registries. This study aimed to develop a set of quality indicators to enable assessment and reporting of quality of care for breast device surgery which can be applied globally.Methods: A scoping literature review was undertaken, and potential quality indicators were identified. Consensus on the final list of quality indicators was obtained using a modified Delphi approach. This process involved a series of online surveys, and teleconferences over 6 months. The Delphi panel included participants from various countries and representation from surgical specialty groups including breast and general surgeons, plastic and reconstructive surgeons, cosmetic surgeons, a breast-care nurse, a consumer, a devices regulator (Therapeutic Goods Administration), and a biostatistician. A total of 12 candidate indicators were proposed: Intraoperative antibiotic wash, intraoperative antiseptic wash, preoperative antibiotics, nipple shields, surgical plane, volume of implant, funnels, immediate versus delayed reconstruction, time to revision, reoperation due to complications, patient satisfaction, and volume of activity.Results: Three of the 12 proposed indicators were endorsed by the panel: preoperative intravenous antibiotics, reoperation due to complication, and patient reported outcome measures.Conclusion: The 3 endorsed quality indicator measures will enable breast device registries to standardize benchmarking of care internationally for patients undergoing breast device surgery.

AB - Background: Breast device registries monitor devices encompassing breast implants, tissue expanders and dermal matrices, and the quality of care and patient outcomes for breast device surgery. Defining a standard set of quality indicators and risk adjustment factors will enable consistency and adjustment for case-mix in benchmarking quality of care across breast implant registries. This study aimed to develop a set of quality indicators to enable assessment and reporting of quality of care for breast device surgery which can be applied globally.Methods: A scoping literature review was undertaken, and potential quality indicators were identified. Consensus on the final list of quality indicators was obtained using a modified Delphi approach. This process involved a series of online surveys, and teleconferences over 6 months. The Delphi panel included participants from various countries and representation from surgical specialty groups including breast and general surgeons, plastic and reconstructive surgeons, cosmetic surgeons, a breast-care nurse, a consumer, a devices regulator (Therapeutic Goods Administration), and a biostatistician. A total of 12 candidate indicators were proposed: Intraoperative antibiotic wash, intraoperative antiseptic wash, preoperative antibiotics, nipple shields, surgical plane, volume of implant, funnels, immediate versus delayed reconstruction, time to revision, reoperation due to complications, patient satisfaction, and volume of activity.Results: Three of the 12 proposed indicators were endorsed by the panel: preoperative intravenous antibiotics, reoperation due to complication, and patient reported outcome measures.Conclusion: The 3 endorsed quality indicator measures will enable breast device registries to standardize benchmarking of care internationally for patients undergoing breast device surgery.

KW - CLINICAL INDICATORS

KW - CANCER SURGERY

KW - DELPHI

KW - OUTCOMES

KW - RISK

KW - CARE

KW - RECONSTRUCTION

U2 - 10.1097/GOX.0000000000002348

DO - 10.1097/GOX.0000000000002348

M3 - Article

VL - 7

JO - Plastic and Reconstructive Surgery – Global Open

JF - Plastic and Reconstructive Surgery – Global Open

SN - 2169-7574

IS - 8

M1 - 2348

ER -