Determining the surgical quality improvement model by outcome monitoring in Hong Kong public hospitals

Aim Reduction in the surgical mortality has been observed in Hong Kong public hospitals after the implementation of the Surgical Outcomes Monitoring and Improvement Program (SOMIP). The aim of the present study was to identify factors and strategies that allow surgeons to improve their outcome after the implementation of the SOMIP. Patients and Methods A qualitative study among surgeons in SOMIP‐participating hospitals using semistructured interviews was performed, with questions focused on knowledge of the SOMIP, comments on SOMIP methodology and actions taken by hospitals to drive quality improvement. Results Fifteen surgeons from five public hospitals in Hong Kong were recruited. The provision of objective data, culture change, surgeons' motivation to improve, advice from external reviewers, leadership and support from administration were identified as factors driving outcome improvement after the implementation of the SOMIP. Most surgeons strongly agreed that SOMIP can be used as a quality improvement tool and there was a need to disclose hospital results. Conclusions A risk‐adjusted, outcome‐based, quality improvement program could provide objective data as feedback to surgical units and benchmark with peers. Together with the driving force from public reporting, change in culture, appropriate resource allocation and service planning, improvement in the structure, process and outcome can be achieved.