Surgical process improvement tools: defining quality gaps and priority areas in gastrointestinal cancer surgery.

A C Wei, K S Devitt, M Wiebe, O F Bathe, R S McLeod, D R Urbach

Abstract read

In one paragraph

Article in Current oncology (Toronto, Ont.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

A C WeiPrincess Margaret Cancer Centre, University Health Network, Department of Surgery, University of Toronto, Toronto, ON. ; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON.

K S DevittPrincess Margaret Cancer Centre, University Health Network, Department of Surgery, University of Toronto, Toronto, ON.

M WiebePrincess Margaret Cancer Centre, University Health Network, Department of Surgery, University of Toronto, Toronto, ON.

O F BatheDepartment of Surgery and Oncology, University of Calgary, Calgary, AB.

R S McLeodInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON. ; Division of General Surgery, Mount Sinai Hospital, Department of Surgery, University of Toronto, Toronto, ON.

D R UrbachPrincess Margaret Cancer Centre, University Health Network, Department of Surgery, University of Toronto, Toronto, ON. ; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgery is a cornerstone of cancer treatment, but significant differences in the quality of surgery have been reported. Surgical process improvement tools (spits) modify the processes of care as a means to quality improvement (qi). We were interested in developing spits in the area of gastrointestinal (gi) cancer surgery. We report the recommendations of an expert panel held to define quality gaps and establish priority areas that would benefit from spits.

methodsThe present study used the knowledge-to-action cycle was as a framework. Canadian experts in qi and in gi cancer surgery were assembled in a nominal group workshop. Participants evaluated the merits of spits, described gaps in current knowledge, and identified and ranked processes of care that would benefit from qi. A qualitative analysis of the workshop deliberations using modified grounded theory methods identified major themes.

resultsThe expert panel consisted of 22 participants. Experts confirmed that spits were an important strategy for qi. The top-rated spits included clinical pathways, electronic information technology, and patient safety tools. The preferred settings for use of spits included preoperative and intraoperative settings and multidisciplinary contexts. Outcomes of interest were cancer-related outcomes, process, and the technical quality of surgery measures.

conclusionsSurgical process improvement tools were confirmed as an important strategy. Expert panel recommendations will be used to guide future research efforts for spits in gi cancer surgery.

Indexed as

cancer surgeryclinical pathwaysknowledge translationpatient safetyperioperative careQuality improvement

Identifiers

PMID24764704

DOI10.3747/co.21.1733

PMCPMC3997452

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.