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Quality Measures in Foot and Ankle Care

Xiong, Grace, MD; Bennett, Chase G., MD; Chou, Loretta, MD; Kamal, Robin N., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: April 15, 2019 - Volume 27 - Issue 8 - p e373–e380
doi: 10.5435/JAAOS-D-17-00733
Research Article
SDC

Background: Quality measures may be operationalized in payment models or quality reporting programs to assess foot and ankle surgeons, but if existing measures allow accurate representation of a foot and ankle surgeon's practice is unclear.

Methods: National quality measures databases, clinical guidelines, and MEDLINE/PubMed were systematically reviewed for quality measures relevant to foot and ankle care. Measures meeting internal criteria were categorized by clinical diagnosis, National Quality Strategy priority, and Donabedian domain.

Results: Of 12 quality measures and 16 candidate measures, National Quality Strategy priorities most commonly addressed “Effective Clinical Care” (n = 19) and “Communication and Coordination of Care” (n = 6). Donabedian classifications addressed were process (n = 25) and outcome (n = 3). Diabetic foot care was most commonly addressed (n = 18).

Conclusions: Available foot and ankle quality measures are limited in number and scope, which may hinder appropriate assessment of care, analysis of trends, and quality improvement. Additional measures are needed to support the transition to a value-based system.

Level of Evidence: Level I

From the Department of Orthopaedic Surgery, Stanford School of Medicine, Redwood City, CA.

Correspondence to Dr. Kamal: rnkamal@stanford.edu

Dr. Bennett or an immediate family member has stock or stock options held in Cardan Robotics and ListRunner. Dr. Chou or an immediate family member has received research or institutional support from Arthrex and Cartiva and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Orthopaedic Foot and Ankle Society. Dr. Kamal or an immediate family member serves as a paid consultant to Acumed and Heron Therapeutics and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand. Neither Dr. Xiong nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2019 by American Academy of Orthopaedic Surgeons
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