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Establishing a National Registry for Hand Surgery

  • Robert L. Kane
    Affiliations
    Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI
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  • Kevin C. Chung
    Correspondence
    Corresponding author: Kevin C. Chung, MD, MS, University of Michigan Comprehensive Hand Center, Section of Plastic Surgery, University of Michigan Health System, 1500 E Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340.
    Affiliations
    Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI
    Search for articles by this author
Published:November 25, 2019DOI:https://doi.org/10.1016/j.jhsa.2019.09.006
      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.

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