Understanding gaps in surgical quality: Learning to count what cannot be counted

摘要

Albert Einstein famously said, "Not everything that can be counted counts and not everything that counts can be counted." This statement certainly rings true in surgical quality. Four decades of research have shown wide variations in surgical outcomes. However, these studies that simply "count" surgical outcomes invariably leave us wanting more. Such studies often conclude with a statement such as "the processes of care leading to better outcomes at high performing hospitals warrants further study." Where do we go to understand the details of care that drive poor outcomes? Thanks to the innovative work of Symons et al in this issue of Annals of Surgery, we now have an idea of where to start.