title: Identifying and defining complications of dermatologic surgery to be tracked in the American College of Mohs Surgery (ACMS) Registry.
abstract: BACKGROUND
  In recent years, increasing emphasis has been placed on value-based health care delivery. Dermatology must develop performance measures to judge the quality of services provided. The implementation of a national complication registry is one such method of tracking surgical outcomes and monitoring the safety of the specialty.
  
  
  OBJECTIVE
  The purpose of this study was to define critical outcome measures to be included in the complications registry of the American College of Mohs Surgery (ACMS).
  
  
  METHODS
  A Delphi process was used to reach consensus on the complications to be recorded.
  
  
  RESULTS
  Four major and one minor complications were selected: death, bleeding requiring additional intervention, functional loss attributable to surgery, hospitalization for an operative complication, and surgical site infection.
  
  
  CONCLUSIONS
  This article addresses only one aspect of registry development: identifying and defining surgical complications.
  
  
  CONCLUSIONS
  The ACMS Registry aims to gather data to monitor the safety and value of dermatologic surgery. Determining and defining the outcomes to be included in the registry is an important foundation toward this endeavor.
authors.affiliation: Division of Dermatology, Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri. Electronic address: mlaurincouncil@gmail.com.
authors.forename: M Laurin
authors.initials: ML
authors.lastname: Council
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Murad
authors.initials: M
authors.lastname: Alam
authors.affiliation: Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Hugh M
authors.initials: HM
authors.lastname: Gloster
authors.affiliation: Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Bordeaux
authors.affiliation: Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Carroll
authors.affiliation: Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Leitenberger
authors.affiliation: Bend Memorial Clinic, Bend, Oregon.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Wisco
authors.affiliation: Department of Dermatology, St Louis University School of Medicine, St Louis, Missouri.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Maher
mesh_terms: D003697:Delphi Technique; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015580:Mohs Surgery / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D012955:Societies, Medical; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States
keywords: American College of Mohs Surgery; Mohs; complications; dermatologic surgery; outcome measures; registry; value-based health care