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(Circulation. 2008;117:2534-2541.)
© 2008 American Heart Association, Inc.

Aortic Diseases

Measuring and Improving the Quality of Care for Abdominal Aortic Aneurysm Surgery

Justin B. Dimick, MD, MPH; Gilbert R. Upchurch, Jr, MD

From the Michigan Surgical Collaborative for Outcomes Research and Evaluation (M-SCORE), and the Section of Vascular Surgery, both in the Department of Surgery, University of Michigan Medical Center, Ann Arbor, Mich.

Correspondence to Justin Dimick, MD, MPH, M-SCORE Offices, 211 N Fourth Ave, Suite 2A, Ann Arbor, MI 48104. Email jdimick@umich.edu

Key Words: aneurysm • aorta • outcome assessment • process measures • quality of health care • surgery

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Because of widespread recognition of variations in surgical performance, patients and payers are placing renewed focus on holding providers accountable for the quality of care they provide. Patients are becoming more cautious informed consumers. Payers are stepping up efforts to align reimbursement to physicians and hospitals with the quality of care they provide. Providers can count on quality measurement and improvement being part of the health policy landscape for the foreseeable future. As stakeholders in this movement, we need to continually refine and update our understanding of the best approach to answer this call for accountability, and each of us needs to fulfill our obligation to contribute to the improvement of our clinical specialty.

The purpose of this article is to update our knowledge on the best methods to approach quality measurement and improvement in aortic surgery. Whereas many agree that improving the quality of care is important, few agree on the best way to go about it. The available approaches to measure the quality of care for high-risk abdominal aortic aneurysm surgery will be reviewed. In addition, the promise and pitfalls of existing improvement efforts will be considered.

Abdominal aortic aneurysm repair is both a relatively common and high-risk procedure. Many patients die each year after elective repair of abdominal aortic aneurysms.¹ Improving the quality of care provided to these patients could potentially avert many of these deaths. For this reason, operations for aortic aneurysm disease are often the focus of quality measurement and improvement. Although most existing quality . . . [Full Text of this Article]