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Neurosurgical Focus Highlights Efforts to Define, Measure, and Predict Quality in Neurosurgery

headshotJohn Ratliff, MD, FAANS, FACS (left)
Co-Director, Division of Spine and Peripheral Nerve Surgery
Department of Neurosurgery Stanford University Medical Center
Chair, AANS/CNS National Quality Council
Stanford, CA

Anthony L. Asher, MD, FAANS, FACS (right)
Co-Medical Director, Carolinas Healthcare System Neuroscience Institute
Director, National Neurosurgery Quality and Outcomes Database
Vice President, NeuroPoint Alliance
Charlotte, NC

Quality reporting continues to grow in importance in our healthcare system. The largest transformation of healthcare processes in modern history is being driven by data derived from everyday patient care. Specifically, this information is being increasingly used to define and to improve the quality of care, with the paired goal of more efficiently allocating scarce healthcare resources. Changes in healthcare reimbursement will incorporate quality measures and quality reporting, making this a routine part of every physician’s practice.

JNSNeurosurgery is actively involved in developing metrics and ensuring that quality measures accurately capture patient outcomes. The efforts of the NeuroPoint Alliance and the National Neurosurgery Quality and Outcomes Database (N²QOD) are vital to this process. In addition to neurosurgery’s clinical data collection initiatives, the AANS/CNS National Quality Council (NQC) is working to expand the development of quality improvement and patient-centered care programs, such as neurosurgical-specific quality measures and episodes of care bundles.

The December 2015 issue of Neurosurgical Focus illustrates these efforts. Its original scientific contributions focus on methods to define neurosurgical quality from the perspective of multiple stakeholders, to accurately measure that quality, and to use accumulated data to predict and improve outcomes of care for individuals or patient populations. These articles describe the importance of developing relevant measures of quality and organized neurosurgery’s recent efforts to create a set of specialty-specific measures for use in quality reporting programs, which will be meaningful to neurosurgeons, their patients, and other healthcare stakeholders. 

Notable articles include:

Neurosurgery has a long tradition of dedication to patient safety and providing high-quality care, and the designation of N2QOD — the NeuroPoint Alliance’s clinical registry focused on spine and neurosurgical outcomes — as a Qualified Clinical Data Registry (QCDR) — allowing neurosurgeons using N2QOD to also satisfy the Centers for Medicare & Medicaid Services (CMS) Physician Quality Reporting System (PQRS) quality reporting requirements — is an important step forward.

The impact of creating robust specialty-specific registry formats goes well beyond facilitating public reporting. Analyses of data collected through the N2QOD have already helped demonstrate the effectiveness of neurosurgical care and identify important care improvement opportunities. With the added incentive of using the N2QOD registry to fulfill PQRS requirements, the volume of collected data should grow exponentially; thereby advancing the science of neurosurgical quality improvement.

Practicing neurosurgeons must understand quality science and its methods as essential components of modern practice. As a specialty, we must define the value of cranial and spinal surgery within the broader realm of medicine and society so our patients can reap the benefits. The articles in this issue of Neurosurgical Focus demonstrate our ability to meet this challenge.

Earlier this year, organized neurosurgery submitted feedback to the Centers for Medicare and Medicaid Services regarding the Medicare Access and CHIP Reauthorization Act (MACRA). Our letter highlighted the benefits of clinical data registries for the Physician Quality Reporting System (PQRS) and Electronic Health Records (EHR) Incentive Program meaningful use (MU) reporting requirements.

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