Woo Russell K, Skarsgard Erik D
Division of Pediatric Surgery, Kapiolani Medical Center for Women and Children, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii.
Division of Pediatric Surgery, BC Children׳s Hospital, University of British Columbia, Vancouver, Canada.
Semin Pediatr Surg. 2015 Jun;24(3):138-40. doi: 10.1053/j.sempedsurg.2015.02.013. Epub 2015 Mar 4.
Innovation in surgical techniques, technology, and care processes are essential for improving the care and outcomes of surgical patients, including children. The time and cost associated with surgical innovation can be significant, and unless it leads to improvements in outcome at equivalent or lower costs, it adds little or no value from the perspective of the patients, and decreases the overall resources available to our already financially constrained healthcare system. The emergence of a safety and quality mandate in surgery, and the development of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) allow needs-based surgical care innovation which leads to value-based improvement in care. In addition to general and procedure-specific clinical outcomes, surgeons should consider the measurement of quality from the patients' perspective. To this end, the integration of validated Patient Reported Outcome Measures (PROMs) into actionable, benchmarked institutional outcomes reporting has the potential to facilitate quality improvement in process, treatment and technology that optimizes value for our patients and health system.
手术技术、技术手段及护理流程的创新对于改善手术患者（包括儿童）的护理及治疗效果至关重要。与手术创新相关的时间和成本可能相当可观，除非它能以同等或更低成本带来治疗效果的改善，否则从患者角度来看，它几乎没有价值，并且会减少我们本就资金紧张的医疗系统可用的整体资源。手术领域安全与质量要求的出现，以及美国外科医师学会国家外科质量改进计划（NSQIP）的发展，使得基于需求的手术护理创新成为可能，从而带来基于价值的护理改善。除了一般的和特定手术的临床结果外，外科医生还应从患者角度考虑质量的衡量。为此，将经过验证的患者报告结局指标（PROMs）整合到可操作的、有基准的机构结局报告中，有可能促进流程、治疗和技术方面的质量改进，从而为我们的患者和医疗系统优化价值。
