The Data Subcommittee of the Committee of Metabolic and Bariatric Surgery oversees all aspects of the MBSAQIP Data Collection Program. Working closely with the MBSAQIP staff, the group determines the data points and definitions, as well as the analyses, and reporting tools used to support the accreditation program. Drs. Matt Hutter and Bruce Wolfe are the co-chairs of the committee, and members include Drs. Ranjan Sudan, John Morton, Tim Jackson and Steve Belle.
connect recently interviewed Dr. Hutter about the process of data collection for MBSAQIP and the role it plays in accreditation and quality improvement. Dr. Hutter is a bariatric surgeon at the Massachusetts General Hospital, and he had helped to lead the development of the current MBSAQIP data collection program since its inception in 2007.
connect: Please describe the data collection component of MBSAQIP.
The goal of the data collection program is to provide high quality data that can be used to drive quality improvement and to inform the accreditation process. All procedures performed at the bariatric and metabolic program are included, and data points include short term outcomes at 30 days, as well as longer term data at six months, one year and yearly thereafter. Data points include traditional outcomes for morbidity like leaks, bleeds, reoperations and readmissions. Data also assesses the clinical effectiveness of the procedures performed, like weight loss and reduction in weight-related comorbidities like diabetes, hypertension, hypercholesterolemia, obstructive sleep apnea and GERD. Results are procedure specific, and can be benchmarked to aggregated outcomes from hospitals across the country.
connect: How is the data collected?
The data is collected by Bariatric Surgical Clinical Reviewers. To assure high quality, objective data, the collectors are not supposed to provide clinical charting on the patients they are assessing. Each collector undergoes in-depth training on data entry and the standard definitions established by MBSAQIP. There is ongoing training too. In fact, we will be introducing new online training modules that include interactive self-assessments to ensure comprehension of all the material. Our goal with these new training modules is to make sure everyone is on the same page and we can use the data to make apples to apples comparisons when reviewing outcomes throughout the country.
connect: Why is there only one data collector at each institution?
The number of data collectors is determined by volume, and most accredited centers require only one. Should the volume be such that more than one collector should be necessary, others can be trained. The reason for having one data collector is to reduce variability, minimize bias and ensure full, high quality data is submitted to our national database. Should there be more than one bariatric group of surgeons at an accredited institution, it would be best if all data were collected in the same objective manner, so all can trust the data, and can focus on quality improvement, rather than how it is collected.
connect: How is the data used?
MBSAQIP data is collected to assess the quality of care provided, so that it can be used for quality improvement. Reports provide national comparisons to benchmark the results from your institution. This can help with the identification of best practices and the ability to provide data-driven feedback to programs in ways that improve quality and enhance patient safety and effectiveness. It can be used to identify areas that need improvement, and then to measure the impact of quality improvement efforts. The data is not collected specifically for research purposes. However, should analyses of the data be informative, they should be presented or published to advance the field of metabolic and bariatric surgery.
connect: Do you think this data should be used for public reporting?
Everybody is interested in measuring quality -- the patients, the payers, the policy makers and the providers all want this. And they will use and report whatever metric for quality that is available, regardless of inherent flaws. Our goal is to use our clinical expertise gained from caring for these surgical patients, to create a rigorous, meaningful metric that accurately reflects the quality of surgical care. High quality, benchmarked, clinically-rich data based on standardized definitions is the key component to create a meaningful metric. If my program were going be judged, and the results were to be publicly reported, I would want that to be based on the MBSAQIP data. The higher the quality of our data and the integrity we bring to its collection, the higher the likelihood that policymakers and payers will look to the MBSAQIP to inform their decision making. But the primary reason we are implementing MBSAQIP is for our patients. We believe this program will improve outcomes and help save lives. Our hope is that all the 700-plus bariatric programs that are participating will become a powerful voice for patients through their data in the MBSAQIP.