Surgical Survival Predictors May Be Next Big Quality Metric

Expectedly, many hospitals aren't ready to volunteer this information. It's controversial, Binder acknowledges. It's embarrassing for some hospitals that don't do as well as their competitors. Hospital and physician groups have balked.

Despite rock-solid scientific evidence supporting the listing of these scores, the National Quality Forum has endorsed survival calculations for just three the six procedures: pancreatic resection, esophageal resection, and abdominal aortic aneurysm repair. So far they've declined to endorse the other three, but Binder thinks they will be eventually.

"There is no measure that has ever gone through the scrutiny and the scientific requirements that these measures went through in the NQF process," Binder told me.

Many more surgical procedures and other high-risk types of hospital procedures will get the same level of scrutiny.

As Binder travels the country speaking to many hospital leaders, she says she's struck by how many non-Leapfrog participants still have their heads in the proverbial sand about transparency, still refusing to release their data.

"A lot of them are hunkering down thinking they can hide this, at least until the value-based purchasing (scores) are made public. They aren't focused at all on this. And I think that couldn't be a worse strategy."

I asked why she thinks hospitals are reluctant. "They think transparency is a problem because so many measures 'can be misinterpreted' that kind of thing," she answers. "But my statement to them is that no measures are perfect. They need to be transparent because that's how they're going to survive."

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