====== Center of excellence ====== A center of excellence (CoE) is an organizational structure or [[team]] dedicated to a particular area of [[expertise]], often aiming to provide [[leadership]], [[best practice]]s, [[research]], [[support]], and [[training]] within that field. CoEs are commonly used in various sectors such as [[healthcare]], [[technology]], and [[education]] to drive [[innovation]] and improve performance. In healthcare, a CoE might focus on a specific type of care or [[treatment]], like a center of excellence in neurosurgery or cancer treatment. These centers are typically recognized for their advanced clinical capabilities, research contributions, and high standards of patient care. ---- Padula et al. in an article, examine how avoidable [[complication]]s, post-acute healthcare use, [[revision surgery]], and [[readmission]]s among [[spine surgery]] patients contribute to $67 million of wasteful spending on value defects. Furthermore, they estimated that almost $27 million of these [[cost]]s could be recuperated simply by redirecting patients to facilities referred to as centers of excellence. In total, [[quality improvement]] efforts are costly to implement but may only cost about $36 million to fully correct the $67 million in finances misappropriated to value defects. The objective of this article is to present an approach to eliminate defects in [[spine surgery]], including a [[center]] of [[excellence]] framework for eliminating defects specific to this group of procedures ((Padula WV, Smith GA, Gordon Z, Pronovost PJ. Value Defects in Spine Surgery: How to Reduce [[Wasteful Care]] and Improve Value. J Am Acad Orthop Surg. 2024 Sep 15;32(18):833-839. doi: 10.5435/JAAOS-D-23-00989. Epub 2024 May 24. PMID: 39240706; PMCID: PMC11384277.))