Innovating for quality and value: Utilizing national quality improvement programs to identify opportunities for responsible surgical innovation
Section snippets
Innovating in a resource-limited environment
The cost of developing new medical technologies is high. In the field of interventional cardiology, the typical process of design, prototyping, and pre-clinical testing lasts 2–3 years and consumes 10–20 million US dollars before a novel technology is ready for initial clinical testing.1 Once clinical testing is underway, the navigation of US and international regulatory processes add significant time and cost to the development process before formal commercialization can begin. If extensive
Value in surgery
In healthcare, value has been defined as: health outcomes/the costs of delivering the outcomes.3 While this may seem an obvious concept, value can be difficult to actually measure when applied to surgical care and, specifically surgical technologies. Traditionally, new and improved surgical devices meant increased cost. This is not necessarily bad as long as the new technologies result in clear outcome improvements—value does not necessarily mean cost reduction. While the initial product cost
National Surgical Quality Program (NSQIP)
While assessing the value of surgical innovations may be challenging, there are increasingly robust tools that may help surgical innovators develop high value technologies. Developed to improve safety and quality in surgical care, the American College of Surgeons׳ National Surgical Quality Improvement Program (NSQIP), which uses validated data processes to provide risk-adjusted surgical outcomes, is perhaps the most mature example of this. Returning to the value equation of health outcomes/the
Paradigms of needs-driven surgical innovation
The use of large quality-based programs to identify opportunities for device and process development represents collaboration between the growing surgical disciplines of safety and quality, and surgical technology innovation. Krummel et al.12 describe innovation as “the process whereby scientific discoveries which could solve clinical problems are driven forward across the translational gap into clinical practice.” Traditionally, this process has not been viewed as being within the core mission
Innovation for value
Future needs-based improvement in pediatric surgical quality will be enabled by a combination of device innovation, process-improvement and standardization, and a greater awareness of quality as it is perceived by the patient. NSQIP data can guide innovation across the health system, as well as at the level of individual hospitals. A thorough cost analysis should be part of any proposed innovation, and those which offer high value in terms of magnitude of outcome improvement or
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Role of patient and family engagement in quality improvement for pediatric surgery
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2019, Technological Forecasting and Social ChangeCitation Excerpt :To successfully implement a transformational change, it is all about implementing a functional ecosystem around the practice instead of individual innovations, technologies, and process solutions (Smith-Strøm et al., 2016). Similarly, Woo and Skarsgard (2015) suggested that a needs-based quality improvement in the pediatric surgery process will be enhanced by a combination of device innovation, revolutionized health connectivity, process improvement, and standardization in addition to greater awareness of quality and value metrics. For this to happen, co-creation with agents and service providers is necessary (Frow et al., 2016).
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