Core measures: implications for plastic surgery

Plast Reconstr Surg. 2013 Jun;131(6):1266-1271. doi: 10.1097/PRS.0b013e31828bd17e.

Abstract

Background: Perioperative complications are a major source of morbidity, mortality, and expenditures in health care. Many of these complications are preventable with simple, cost-effective measures when implemented in a standardized manner. Surgical specialties are increasing efforts to implement standardized and easily monitored measures to reduce perioperative complications.

Methods: The recommendations provided by the U.S. Department of Health and Human Services and published by the Joint Commission on Accreditation of Healthcare Organizations were summarized as they pertain to plastic surgery. A review of recent plastic surgery literature was pursued to evaluate these recommendations as they pertain to the specialty.

Results: Measures exist to reduce the incidence of perioperative infection, venous thromboembolism, and mortality associated with cardiac events. These measures include type and timing of prophylactic antibiotics, maintenance of perioperative normothermia, appropriate hair removal, early discontinuation of urinary catheters, appropriate venous thromboembolism prophylaxis, and use of preoperative beta-blockers.

Conclusions: As national quality measures are implemented across an increasing number of specialties, the expansions will likely affect plastic surgery. These measures are evidence based and validated across a diverse group of surgical specialties, resulting in improved measured outcomes. Plastic surgeons would benefit by actively providing leadership as these and similar measures are implemented.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / adverse effects
  • Adult
  • Aged
  • Antibiotic Prophylaxis / standards
  • Body Temperature
  • Cause of Death
  • Education, Medical, Continuing*
  • Evidence-Based Medicine / standards
  • Female
  • Hair Removal / standards
  • Humans
  • Hypothermia / etiology
  • Hypothermia / mortality
  • Hypothermia / prevention & control
  • Intraoperative Care / methods
  • Intraoperative Care / standards
  • Male
  • Middle Aged
  • Monitoring, Physiologic / standards
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Myocardial Infarction / prevention & control*
  • Plastic Surgery Procedures / education*
  • Plastic Surgery Procedures / standards*
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / prevention & control*
  • Surgery, Plastic / education*
  • Surgery, Plastic / standards*
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / mortality
  • Surgical Wound Infection / prevention & control*
  • Urinary Catheterization / standards
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / mortality
  • Urinary Tract Infections / prevention & control
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / mortality
  • Venous Thromboembolism / prevention & control*

Substances

  • Adrenergic beta-Antagonists