Looking Beyond Perioperative Morbidity and Mortality as Measures of Surgical Quality

Perioperative morbidity and mortality (M&M) have withstood the test of time and continue to be “gold standard” outcomes for both surgical research and quality improvement (QI) programs. Both are easily interpretable and are an important part of high quality care. However, both the quality and safety of surgical care have improved dramatically over time¹ and it is unclear if focusing surgical QI efforts only on M&M remains the best strategy. Specifically, should alternative measures be implemented into the existing infrastructure and analytic frameworks of current national surgical QI and reimbursement programs? Herein, we discuss the problems with a contemporaneous focus on M&M as surgical quality measures and offer potential alternative options which could better refine and evolve surgical quality measurement.