Outcome quality assessment by surgical process compliance measures in laparoscopic surgery.
OBJECTIVE
The effective and efficient assessment, management, and evolution of surgical processes are intrinsic to excellent patient care. Hence, in addition to economic interests, the quality of the outcome is of great importance. Process benchmarking examines the compliance of an intraoperative surgical process to another process that is considered as best practice. The objective of this work is to assess the relationship between the course and the outcome of surgical processes of the study.


METHODS
By assessing 450 skill practices on rapid prototyping models in minimally invasive surgery training, we extracted descriptions of surgical processes and examined the hypothesis that a significant relationship exists between the course of a surgical process and the quality of its outcome.


RESULTS
The results showed a significant correlation with Person correlation coefficients >0.05 between the quality of process outcome and process compliance for simple and complex suturing tasks in the study.


CONCLUSIONS
We conclude that high process compliance supports good quality outcomes and, therefore, excellent patient care. We also showed that a deviation from best training processes led to a decreased outcome quality. This is relevant for identifying requirements for surgical processes, for generating feedback for the surgeon with regard to human factors and for inducing changes in the workflow in order to improve the outcome quality.
Innovation Center Computer Assisted Surgery, Universität Leipzig, Semmelweisstr. 14, D-04103 Leipzig, Germany.
Sandra
S
Schumann
Department of Pediatric Surgery, University Medical Center, Liebigstr. 20a, D-04103 Leipzig, Germany.
Ulf
U
Bühligen
Innovation Center Computer Assisted Surgery, Universität Leipzig, Semmelweisstr. 14, D-04103 Leipzig, Germany. Electronic address: thomas.neumuth@medizin.uni-leipzig.de.
Thomas
T
Neumuth
D006801:Humans; D010535:Laparoscopy; D010043:Outcome and Process Assessment, Health Care; D025321:Surgery, Computer-Assisted; D057188:Workflow
Best practice; Computer-assisted surgery [E02.950.875]; Distance measures; Process benchmarking; Process compliance; Quality of outcome; Surgical process model; Workflow [L01.906.893]