Identification of consensus-based quality end points for colorectal surgery

Mark L. Manwaring, Clifford Y. Ko, James W. Fleshman, David E. Beck, David J. Schoetz, Anthony J. Senagore, Rocco Ricciardi, Larissa K. Temple, Arden M. Morris, Conor P. Delaney

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND: Process and outcome measures for quality assessment of colorectal surgical care are poorly defined. OBJECTIVE: The aim of this study was to develop candidate end points for use in surgeon-specific registries designed for case reporting and quality improvement program development. DESIGN: The study design was based on modified Delphibased development of consensus quality end points. SETTING: This study was undertaken by the American Society of Colon and Rectal Surgeons Executive Council, Quality Committee, and by the ColoRectal Education System Template Committee, American Board of Colon and Rectal Surgery. PATIENTS: No patients were included in this study. INTERVENTIONS: Six areas of colorectal surgery were defined by members of the American Society of Colon and Rectal Surgeons' Executive Council and the American Board of Colon and Rectal Surgery to cover areas of importance for colorectal surgeons. These included colectomy, rectal cancer, hemorrhoidectomy, anal fistula and abscess, colonoscopy, and rectal prolapse. Relevant American Society of Colon and Rectal Surgeons' committee members through a series of 4 panel discussions identified important demographic, process, and outcome measures in each of these 6 areas that might be suitable for the American College of Surgeons case log. Panel size was sequentially expanded from 8 members to 28 members to include all active committee members. Panelists contributed additional process and outcome measures for inclusion during each discussion. Modified Delphi methodology was used to generate consensus, and, after each panel discussion, members rated the relative importance of each end point from 1 (least important) to 4 (most important). MAIN OUTCOME MEASURES: The mean rating for each process and outcome measure after each round was recorded with the use of standardized definitions for relevant variables. RESULTS: Eighty-nine process and outcome measures were compiled and rated. Mean scores following the final round ranged from a low of 1.3 (anal fistula/abscess, preoperative imaging) to a high of 4.0 (colectomyanastomotic leak). LIMITATIONS: The limitations of this study involved the use of consensus, small study size, and the fact that no end points were excluded. CONCLUSIONS: With the use of modified Delphi methodology, a consensus-derived ranked list of 89 process and outcome measures was developed in 6 key areas of colorectal surgery. These data provide a framework for development of guideline standards for case-reporting program development initiatives for colon and rectal surgery.

Original languageEnglish (US)
Pages (from-to)294-301
Number of pages8
JournalDiseases of the Colon and Rectum
Volume55
Issue number3
DOIs
StatePublished - Mar 2012
Externally publishedYes

Fingerprint

Colorectal Surgery
Process Assessment (Health Care)
Consensus
Outcome Assessment (Health Care)
Rectal Fistula
Committee Membership
Colon
Program Development
Abscess
Hemorrhoidectomy
Rectal Prolapse
Colectomy
Colonoscopy
Rectal Neoplasms
Quality Improvement
Registries
Demography
Guidelines
Education

Keywords

  • Case log
  • Colorectal
  • Consensus
  • Outcomes
  • Process
  • Quality

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Manwaring, M. L., Ko, C. Y., Fleshman, J. W., Beck, D. E., Schoetz, D. J., Senagore, A. J., ... Delaney, C. P. (2012). Identification of consensus-based quality end points for colorectal surgery. Diseases of the Colon and Rectum, 55(3), 294-301. https://doi.org/10.1097/DCR.0b013e318241b11f

Identification of consensus-based quality end points for colorectal surgery. / Manwaring, Mark L.; Ko, Clifford Y.; Fleshman, James W.; Beck, David E.; Schoetz, David J.; Senagore, Anthony J.; Ricciardi, Rocco; Temple, Larissa K.; Morris, Arden M.; Delaney, Conor P.

In: Diseases of the Colon and Rectum, Vol. 55, No. 3, 03.2012, p. 294-301.

Research output: Contribution to journalArticle

Manwaring, ML, Ko, CY, Fleshman, JW, Beck, DE, Schoetz, DJ, Senagore, AJ, Ricciardi, R, Temple, LK, Morris, AM & Delaney, CP 2012, 'Identification of consensus-based quality end points for colorectal surgery', Diseases of the Colon and Rectum, vol. 55, no. 3, pp. 294-301. https://doi.org/10.1097/DCR.0b013e318241b11f
Manwaring ML, Ko CY, Fleshman JW, Beck DE, Schoetz DJ, Senagore AJ et al. Identification of consensus-based quality end points for colorectal surgery. Diseases of the Colon and Rectum. 2012 Mar;55(3):294-301. https://doi.org/10.1097/DCR.0b013e318241b11f
Manwaring, Mark L. ; Ko, Clifford Y. ; Fleshman, James W. ; Beck, David E. ; Schoetz, David J. ; Senagore, Anthony J. ; Ricciardi, Rocco ; Temple, Larissa K. ; Morris, Arden M. ; Delaney, Conor P. / Identification of consensus-based quality end points for colorectal surgery. In: Diseases of the Colon and Rectum. 2012 ; Vol. 55, No. 3. pp. 294-301.
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