Performance Measurement in Surgery

2016 ◽  
Author(s):  
Justin B. Dimick
Keyword(s):  
Gastric Bypass ◽  
Performance Measurement ◽  
Outcome Measures ◽  
Performance Measures ◽  
Laparoscopic Gastric Bypass ◽  
Quality Measures ◽  
Technical Skill ◽  
Process Of Care ◽  
Surgical Quality ◽  
Health Care Structure

With growing recognition that the quality of surgical care varies widely, good measures of performance are in high demand. An ever-broadening array of performance measures is being developed to meet these different needs; however, considerable uncertainty remains about which measures are most useful for measuring surgical quality. Current measures encompass different elements of health care structure, process of care, and patient outcomes. This review covers overview of surgical quality measures, categories of quality measures, structural measures of quality, process of care measures, direct outcome measures, matching the measure to the purpose, improving existing performance measures, and the future of performance measurement. Figures show relative ability of historical (2005-2006) measures of hospital volume and risk-adjusted mortality to predict subsequent (2007-2008) risk-adjusted mortality in US Medicare patients,  risk-adjusted mortality and morbidity for colon resection at individual hospitals before and after adjustment for reliability, variation in surgeon technical skill for 20 bariatric surgeons performing laparoscopic gastric bypass in the Michigan Bariatric Surgery Collaborative (MBSC), and relationship of surgeon technical skill and risk-adjusted complications and resource use after laparoscopic gastric bypass in the MBSC. The table lists primary strengths and limitations of structure, process, and outcome measures.   This review contains 4 highly rendered figures, 1 table, and 34 references

Performance Measurement in Surgery

2017 ◽  
Author(s):  
Justin B. Dimick
Keyword(s):  
Gastric Bypass ◽  
Performance Measurement ◽  
Outcome Measures ◽  
Performance Measures ◽  
Laparoscopic Gastric Bypass ◽  
Quality Measures ◽  
Technical Skill ◽  
Process Of Care ◽  
Surgical Quality ◽  
Health Care Structure

With growing recognition that the quality of surgical care varies widely, good measures of performance are in high demand. An ever-broadening array of performance measures is being developed to meet these different needs; however, considerable uncertainty remains about which measures are most useful for measuring surgical quality. Current measures encompass different elements of health care structure, process of care, and patient outcomes. This review covers overview of surgical quality measures, categories of quality measures, structural measures of quality, process of care measures, direct outcome measures, matching the measure to the purpose, improving existing performance measures, and the future of performance measurement. Figures show relative ability of historical (2005-2006) measures of hospital volume and risk-adjusted mortality to predict subsequent (2007-2008) risk-adjusted mortality in US Medicare patients,  risk-adjusted mortality and morbidity for colon resection at individual hospitals before and after adjustment for reliability, variation in surgeon technical skill for 20 bariatric surgeons performing laparoscopic gastric bypass in the Michigan Bariatric Surgery Collaborative (MBSC), and relationship of surgeon technical skill and risk-adjusted complications and resource use after laparoscopic gastric bypass in the MBSC. The table lists primary strengths and limitations of structure, process, and outcome measures.   This review contains 4 highly rendered figures, 1 table, and 34 references

Performance Measurement in Surgery

2015 ◽  
Author(s):  
Justin B. Dimick
Keyword(s):  
Gastric Bypass ◽  
Performance Measurement ◽  
Outcome Measures ◽  
Performance Measures ◽  
Laparoscopic Gastric Bypass ◽  
Quality Measures ◽  
Technical Skill ◽  
Process Of Care ◽  
Surgical Quality ◽  
Health Care Structure

With growing recognition that the quality of surgical care varies widely, good measures of performance are in high demand. An ever-broadening array of performance measures is being developed to meet these different needs; however, considerable uncertainty remains about which measures are most useful for measuring surgical quality. Current measures encompass different elements of health care structure, process of care, and patient outcomes. This review covers overview of surgical quality measures, categories of quality measures, structural measures of quality, process of care measures, direct outcome measures, matching the measure to the purpose, improving existing performance measures, and the future of performance measurement. Figures show relative ability of historical (2005-2006) measures of hospital volume and risk-adjusted mortality to predict subsequent (2007-2008) risk-adjusted mortality in US Medicare patients,  risk-adjusted mortality and morbidity for colon resection at individual hospitals before and after adjustment for reliability, variation in surgeon technical skill for 20 bariatric surgeons performing laparoscopic gastric bypass in the Michigan Bariatric Surgery Collaborative (MBSC), and relationship of surgeon technical skill and risk-adjusted complications and resource use after laparoscopic gastric bypass in the MBSC. The table lists primary strengths and limitations of structure, process, and outcome measures.   This review contains 4 highly rendered figures, 1 table, and 34 references

Managing Value Creation within the Firm: An Examination of Multiple Performance Measures

2004 ◽  
Vol 16 (1) ◽  
pp. 107-131 ◽  
Author(s):  
Lisa Bryant ◽  
Denise A. Jones ◽  
Sally K. Widener
Keyword(s):  
Performance Measurement ◽  
Outcome Measures ◽  
Performance Measures ◽  
Measurement System ◽  
Value Creation ◽  
Balanced Scorecard ◽  
Business Processes ◽  
Performance Measurement System ◽  
Cross Sectional ◽  
Performance Measurement Systems

There has been an emphasis in recent years on understanding how value is created within the firm. To understand what drives value, managers must have in place performance measurement systems designed to capture information on all aspects of the business, not just the financial results. Many firms are implementing a Balanced Scorecard (BSC) performance measurement system that tracks measures across four hierarchical perspectives: learning and growth, internal business processes, customer, and financial perspectives. Although BSCs should ideally be tailored to each firm's unique strategy, evidence shows that managers tend to rely on generic measures, particularly as measures of the outcome of each perspective. We use cross-sectional data on seven archival measures from 125 firms over a five-year period to proxy for typical outcome measures of the four BSC perspectives. We find that a model that allows each outcome measure to be associated with outcome measures in all higherlevel BSC perspectives captures the value-creation process better than a relatively simple model that allows each measure to be a driver of only the next perspective in the BSC hierarchy. We also find differences in the relations among performance measures when firms implement a performance measurement system that contains both financial and nonfinancial measures versus one that relies solely on financial measures.

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