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
C2 - 31592377
SN - 2169-7574
VL - 7
JO - Plastic and Reconstructive Surgery – Global Open
JF - Plastic and Reconstructive Surgery – Global Open
IS - 8
M1 - e2348
ER -
