How to fill the surgical quality gap

August 8th,2017, Author / Editor: GENIFYLenz Nölkel

For diagnosing and treating the surgical quality gap a video-based assessment will be necessary. Numerous medical publications in specialist journals over the past years have shown that a broader understanding and interest is being built on this important topic.

The goals of the new digital method are firstly to increase the workflow efficiency and on the other hand to improve the clinical results. But what about surgical outcome variability? Why is it that, in spite of the increased implementation of digitally-integrated workflows, not all surgeries are created equal?
 
This was the focus of a recent study conducted at the University of Michigan which addressed variability of surgical outcomes following minimally-invasive Laparoscopic Colectomy (LC).

Minimally-invasive Laparoscopic Colectomy

The results of the study show that the variability of complication rates following LC was found to be two times higher among surgeons than it was for the same surgeons conducting Open Colectomy (OC), despite the increased risk profile and generally higher rate of complication for OC.
 
But attention please:  the variability of the result refers less to the chosen surgery itself and more to the application of the chosen technique of the surgeon. Thus the quality gap revealed by these studies indicates the need for a more “surgical-centric” approach to quality improvement.

Laparoscopic surgeons receive extensive LC-specific training

It is fortunately so that laparoscopic surgeons receive extensive LC-specific training throughout residency and fellowship, and traditionally, participate in continuing education via surgical society meetings, cadaveric courses, and other MIS training forums. The majority of laparoscopic surgeons arrive to the well-trained and knowledgeable latest techniques.
 
The most crucial step is often skipped: quality review and proctoring. Without experienced guidance, a surgeon recently trained in the latest LC techniques is unlikely to optimally apply their newly acquired skills in the surgical setting. And without access to the means of procedural assessment, the surgeon lacks the resources to self-improve.

With a video-based assessment to new discoveries

Everything indicates to the need of a video-based assessment, as well as to self-evaluation. According to study results which are carried out so far, the success potential of this new methode is high. In addition, surgical abilities were strongly correlated with clinical outcomes.
 
To sum up the implementation of video-based surgical assessment can lead to important procedural discoveries, and the first incremental gains that are required to create a positive momentum to create new skills assessment protocols.

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