Quality in neurosurgery [Neurosurgery Wiki]

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====== Quality in neurosurgery======

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[[value]] = quality/[[cost]]

Prolonged [[length of stay]] (pLOS), [[disease]]-related [[complication]]s, and 30-day [[readmission]]s are important [[quality metrics]] under the [[Affordable Care Act]].
----
see [[ACS National Surgical Quality Improvement Program]].

The [[Grading of Recommendations Assessment Development and Evaluation]] (short GRADE) working group began in the year 2000 as an informal collaboration of people with an interest in addressing the shortcomings of [[grading system]]s in health care. The working group has developed a common, sensible and transparent approach to grading [[quality]] (or certainty) of evidence and strength of recommendations. Many international organizations have provided input into the development of the GRADE approach which is now considered the standard in guideline development.

Public and private insurers want to add quality into the payment calculation, rather than paying for quantity only. 

Quality care can be defined as a process that achieves predefined goals without significant error and maintains or improves health
((Berkowitz O, Jones K, Lunsford LD, Kondziolka D. Determining the elements of
procedural quality. J Neurosurg. 2013 Aug;119(2):373-80. doi:
10.3171/2013.1.JNS111681. Epub 2013 Feb 8. PubMed PMID: 23394334.
)).

Quality and [[safety]] are basic concerns in any medical practice. Especially in daily surgical practice, with increasing turnover and shortened procedure times, attention to these topics needs to be assured. 

In order to deliver to our patients the best quality of care, a certain level of proficiency and competence needs to be attained and maintained. This is true for all areas of neurosurgery and constitutes a realistic objective in the treatment of most pathologies.

===== Quality assurance =====

[[Quality assurance]].

===== Quality of care =====

see [[Quality of care]].

===== Quality of life =====

see [[Quality of life]].


===== Methodological quality =====
[[Method]]ological [[quality]] refers to the level of [[rigor]] and [[validity]] in the [[design]], [[implementation]], and [[analysis]] of a [[research]] study. In other words, it refers to how well a study has been conducted and how confident we can be in its findings.

Some factors that can affect methodological quality include the [[sampling]] method, [[data collection]] techniques, the use of appropriate [[measure]]s and statistical analyses, the control of [[confounding]] variables, and the reporting of [[results]]. A study with high methodological quality is more likely to produce reliable and accurate results and to be considered trustworthy by other researchers and the scientific community. 

===== Quality indicator =====

[[Quality indicator]].

===== Quality Assessment =====

[[Quality Assessment]]
===== Quality Improvement =====

see [[Quality improvement]]. 

===== External validation =====

[[External validation]]

===== Books =====

Quality and Safety in Neurosurgery