Review article
The first metabolic and bariatric surgery accreditation and quality improvement program quality initiative: Decreasing readmissions through opportunities provided

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Rationale

The current MBSAQIP standards require each hospital to perform at least 1 annual quality improvement project. In prioritizing quality improvement efforts, it is critical to find opportunities for improvement that are preventable and actionable. With mortality rates and specific complications, such as anastomotic leaks, becoming increasingly rare, other quality metrics must be investigated. Thirty-day readmission rates are an important quality metric. Readmission rates are a meta-outcome, which

Mechanisms for decreasing readmission rates

The first aspect of quality improvement is definition and measurement. There should be a distinction between 23-hour readmissions and readmissions>24 hours given the difference in acuity and intervention between both types of readmissions. In addition, the readmission capture rate should include readmissions to not only the index hospital but to other hospitals as well. MBSAQIP is able to accomplish both of these tasks as well as provide an opportunity to benchmark individual hospital results

Next steps

As MBSAQIP moves forward, quality improvement will be a critical component. The first quality improvement project for MBSAQIP will be a reduction in 30-day readmissions. Utilizing proven processes, the national goal for MBSAQIP will be to reduce readmissions within 30 days by 20%. In addition to the above-mentioned processes, MBSAQIP will work with establishing standardized preoperative educational modules in surgery, nursing, nutrition, psychology and pharmacology. Other national initiative

Disclosures

The author has no commercial associations that might be a conflict of interest in relation to this article.

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Presented at the Annual Meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS), November 16, 2013, Atlanta, Georgia.

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