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. 2016 Jan;46(1):38-47.
doi: 10.1007/s00595-015-1146-y. Epub 2015 Mar 24.

National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency

Mitsukazu Gotoh  1   2 , Hiroaki Miyata  3   4 , Hideki Hashimoto  3   4 , Go Wakabayashi  4 , Hiroyuki Konno  3   4 , Shuichi Miyakawa  5 , Kenichi Sugihara  3 , Masaki Mori  3 , Susumu Satomi  3 , Norihiro Kokudo  3 , Tadashi Iwanaka  3
Affiliations

National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency

Mitsukazu Gotoh et al. Surg Today. 2016 Jan.

Abstract

The National Clinical Database (NCD) of Japan was established in April, 2010 with ten surgical subspecialty societies on the platform of the Japan Surgical Society. Registrations began in 2011 and over 4,000,000 cases from more than 4100 facilities were registered over a 3-year period. The gastroenterological section of the NCD collaborates with the American College of Surgeons' National Surgical Quality Improvement Program, which shares a similar goal of developing a standardized surgical database for surgical quality improvement, with similar variables for risk adjustment. Risk models of mortality for eight procedures; namely, esophagectomy, partial/total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis, have been established, and feedback reports to participants will be implemented. The outcome measures of this study were 30-day mortality and operative mortality. In this review, we examine the eight risk models, compare the procedural outcomes, outline the feedback reporting, and discuss the future evolution of the NCD.

Keywords: Gastrointestinal surgery; Mortality; National Clinical Database; Nationwide web-based database; Risk model.

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Figures

Fig. 1
Fig. 1
The National Cancer Database feedback system includes a risk calculator for the mortality and morbidity of preoperative patients (left schema) and performance reports of each participating hospital (right schema). The latter includes each facility’s severity-adjusted clinical performance (benchmark) in comparison with the national data (a) and the risk-adjusted cumulative expected–observed death (b). Better (right) or worse (left) outcomes can be detected by the monitoring report
See this image and copyright information in PMC

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