Dear CSS Members and Colleagues:
Enclosed is the Outcomes Questionnaire I submitted to our membership. I am please that 75 surgeons answered and all felt that measurement of outcomes is an essential part of care. This is especially important to me as our group as defined on our home page says we are….
“A group committed to recording the "end result" for every patient, determining best practices and optimizing outcomes in shoulder surgery, just as Dr. Codman envisioned.”
Sadly, while we all agree on the importance of such measurement there are practical barriers which are evident in your answers. These include, among other reasons:
Regulatory barriers at the institution where we work; 3rd party not permitted for measurement
Lack of EPIC and other EMR integration
Insufficient funding to pay for a registry
Insufficient funding and staff to actually enroll patients and manage outcomes measurement
Lack of time
Lack of patient literacy to complete the task
In addition, it is evident we use many different measurement tools and all of these don’t actually measure the same things.
Finally, most of us believe the main purpose of measurement is to improve our care.
I thought it was about time we took stock in where we all stand on the question of measurement, as after all, we exist in the context of Codman whose principle tenant was that measurement is the foundation for all innovation and improvement of care. I welcome your input following which I’ll make several proposals about how we can improve in how and what we measure and how this might actually be the basis for architecting a value-based approach to care.
JP Warner, MD