Quality Outcomes Database Spine Care Project 2012-2020: milestones achieved in a collaborative North American outcomes registry to advance value-based spine care and evolution to the American Spine Registry

Neurosurg Focus. 2020 May 1;48(5):E2. doi: 10.3171/2020.2.FOCUS207.

Abstract

The Quality Outcomes Database (QOD), formerly known as the National Neurosurgery Quality Outcomes Database (N2QOD), was established by the NeuroPoint Alliance (NPA) in collaboration with relevant national stakeholders and experts. The overarching goal of this project was to develop a centralized, nationally coordinated effort to allow individual surgeons and practice groups to collect, measure, and analyze practice patterns and neurosurgical outcomes. Specific objectives of this registry program were as follows: "1) to establish risk-adjusted national benchmarks for both the safety and effectiveness of neurosurgical procedures, 2) to allow practice groups and hospitals to analyze their individual morbidity and clinical outcomes in real time, 3) to generate both quality and efficiency data to support claims made to public and private payers and objectively demonstrate the value of care to other stakeholders, 4) to demonstrate the comparative effectiveness of neurosurgical and spine procedures, 5) to develop sophisticated 'risk models' to determine which subpopulations of patients are most likely to benefit from specific surgical interventions, and 6) to facilitate essential multicenter trials and other cooperative clinical studies." The NPA has launched several neurosurgical specialty modules in the QOD program in the 7 years since its inception including lumbar spine, cervical spine, and spinal deformity and cerebrovascular and intracranial tumor. The QOD Spine modules, which are the primary subject of this paper, have evolved into the largest North American spine registries yet created and have resulted in unprecedented cooperative activities within our specialty and among affiliated spine care practitioners. Herein, the authors discuss the experience of QOD Spine programs to date, with a brief description of their inception, some of the key achievements and milestones, as well as the recent transition of the spine modules to the American Spine Registry (ASR), a collaboration between the American Association of Neurological Surgeons and the American Academy of Orthopaedic Surgeons (AAOS).

Keywords: AANS = American Association of Neurological Surgeons; AAOS = American Academy of Orthopaedic Surgeons; ASR; ASR = American Spine Registry; American Spine Registry; CMS = Centers for Medicare and Medicaid Services; CNS = Congress of Neurological Surgeons; IHI = Institute for Healthcare Improvement; NPA = NeuroPoint Alliance; PRO; PRO = patient-reported outcome; QCDR = Qualified Clinical Data Registry; QI = quality improvement; QOD; QOD = Quality Outcomes Database; Quality Outcomes Database; VIMPH = Vanderbilt Institute for Medicine and Public Health; discharge disposition; lumbar spine; patient-reported outcome; spine surgery.

MeSH terms

  • Benchmarking
  • Clinical Trials as Topic
  • Humans
  • Neurosurgery / methods
  • Neurosurgery / standards
  • Neurosurgery / statistics & numerical data*
  • Neurosurgical Procedures / statistics & numerical data*
  • Orthopedics / statistics & numerical data*
  • Quality of Health Care*
  • Registries*
  • Spinal Diseases / surgery*
  • Spine / surgery*
  • United States