Developing Quality Measures in Otolaryngology-Head and Neck Surgery

However, he stressed that you do not want outcomes based on quick and dirty measurements to be used for determining things like pay or renewal of licensure.

We should let policy makers know that we’re happy with ‘quick and dirty’ measures if what’s on the table is simply a quality improvement effort, he said. On the other hand, if what’s being proposed is a high-stakes measure-something that will be used for payment or licensure-we should absolutely insist on high-quality, statistically meaningful measures.

Quality Relates to Both Physician and System Performance

Although performance measures often focus on individual physician performance, Dr. Roberson emphasized that physician performance, as well as the system in which the physician performs, are integral to assessing quality in modern medical practice.

It is not enough in 2008 to be a good doctor, he said. A surgeon in 2008 is both a surgeon and the leader of a high-performance team.

To this end, any measurement of quality needs to take into consideration the entire system in which the patient moves throughout his or her care. For Dr. Roberson, this highlights the ethical obligation physicians have to improve their own skills and how they interact with the system, as well as being involved in improving how the system works overall. For example, he said, if your resident and ICU nurse do not get along, put that on your radar screen.

Get Involved

With increased recognition of the high cost of medical care and the gaps in quality of care, efforts are under way to develop and implement performance measures to ensure delivery of the highest quality of care at the lowest cost. Over the next decade, physicians will increasingly be asked to demonstrate performance based on established metrics that will determine what they are paid and whether their licenses are renewed. To ensure that these metrics are actually meaningful and indicative of true quality that focuses on patient care, physicians need to get involved in developing relevant performance measures. Otolaryngologists-head and neck surgeons who need help navigating the different quality improvement initiatives or want to get involved in developing performance measures can contact the AAO-HNS at qualityimprovement@entnet.org.

A Tale of Two Organizations

American Academy of Otolaryngology-Head and Neck Surgery
Alexandria, Virginia
A membership organization involved in education, research, and advocacy for otolaryngologists.

American Board of Otolaryngology
Houston, Texas
The organization that certifies otolaryngologists and is responsible for the Maintenance of Certification program.

Medical Organizations Developing, Endorsing, or Utilizing Performance Measures

• Ambulatory Care Quality Alliance (AQA)
• Centers for Medicare and Medicaid Services (CMS)
• National Committee for Quality Assurance (NCQA)
• National Quality Forum (NQF)
• National Surgical Quality Improvement Program (NSQIP)
• Physician Consortium for Performance Improvement (PCPI)
• Surgical Quality Alliance (SQA)
• Specialty societies

©2008 The Triological Society