Surgery is surgery, right? Hernias and intestinal repairs? Gall bladders and appendectomies? Whether they're prompted by a 911 call or scheduled a week in advance?
No, not anymore. Or at least they shouldn't be. In fact, the quality and outcomes of these procedures depend enormously on whether the patient's medical issue is rushed to the operating room emergently, or is done with a scheduled elective appointment.
That's the view of a group of surgical researchers at Wake Forest University Medical Center, who say that although these two entry points involve dramatically different variables and risk equations, hospitals generally lump all of a general surgeon's operative patients together when judging quality.
When hospital quality chiefs review surgeon mishaps, say in morbidity and mortality reports each month, factors that influenced the outcome both within and outside of the provider's control are not studied as a group.
In fact, emergency surgery oversight might work better if it operated a lot more like how the national and regional trauma systems function today, with their own separate patient registries, they suggest. Members of this Wake Forest group have developed just such a registry to prove their point.