Hand surgery leadership in the United States must identify and define what quality
care means for its patients. To achieve this, the surgical team needs a standardized
framework to track and improve quality. This is necessary not only in our value-based
health care system but also in light of considerable provider variation in the management
of common hand conditions and the ongoing need for evidence-based guidelines to inform
decision-making. Building a national registry for the field of hand surgery could
be the solution and warrants serious consideration. A registry designed by hand surgery
experts can collect data on process and outcome measures that are meaningful and specific
to patients with hand conditions. These data inform the surgical team regarding where
to focus their efforts for improvement. Existing methods of quality measurement are
not compatible with hand surgery, a field with an ambulatory setting and rare incidence
of mortality. Patient-reported outcomes, such as health-related quality of life, represent
a more useful measure of quality for hand surgery and are just one example of the
type of data that could be tracked using a national registry. An investment in a large-scale
registry could seamlessly integrate patient preferences, values, and expectations
into clinical practice so that desired outcomes can be delivered consistently across
the nation.
Key words
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Article info
Publication history
Published online: November 25, 2019
Accepted:
September 23,
2019
Received:
September 4,
2019
Footnotes
K.C.C. receives funding from the National Institutes of Health and book royalties from Wolters Kluwer and Elsevier. He has received financial support from Axogen to attend conferences. The other author declares that there are no relevant conflicts of interest.
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Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
