Quality metrics should be followed and measured closely by physicians of all backgrounds and expertise, including sports medicine physicians. While there are certain quality metrics that can be commonly applied to all physicians, such as rate of infections, quality metrics for specifically sports medicine should also be closely measured. David Geier, MD, orthopedic surgeon and sports medicine specialist with Medical University of South Carolina in Charleston, shares four key considerations for measuring quality metrics in sports medicine.
1. Measure patients' rate of return to sports. One quality metric Dr. Geier says is hugely underutilized in the field of sports medicine is the patient's return to his or her respective sport. This metric is important, as it allows sports medicine physicians to study and measure the success rate at which they are able to help their patients get back to their sports at the same or higher level previous to the injury.
"With the [return to sports] quality metric, sports physicians not only want to measure the rate at which patients get back to that sport or activity at the same or higher level but also how long it takes to help patients get there," Dr. Geier says. "Those are two huge metrics and are the basis for why sports medicine physicians get into this field of medicine and why patients go see a sports medicine physician."
2. Carefully consider how to follow patients post-surgery. Adequate quality measuring means physicians need to follow their patients post-surgery to measure a wide array of outcomes, including infections, complications and return to sports. Dr. Geier says how long sports medicine physicians choose to follow their patients for and the method of following them should depend on the sport, nature of the injury, the procedure and the patient.
"Typically, what most sports medicine physicians do with surgical injuries is they follow their patients until they are cleared to play [their sports] and then the patients are responsible for calling their physician if they have any problems," he says. "There are some instances that require physicians to follow patients longer, such as kids who may not be done growing."
Sports medicine physicians can also rely on various tools to test how a patient's condition has improved or not improved over a certain period of time. "[For patients playing in team sports], there are muscle strength testing and functional drills sports medicine physicians can use, but that is entirely up to individual physicians," Dr. Geier says.
3. Outcomes scores should be stratified. Similarly to how sports medicine physicians should post-surgically follow patients on an individual basis, outcomes scores, as it relates to quality measures, should also be stratified based on the sport, nature of the injury and the surgery and the patient.
"The differences in outcomes may not even be related to individual patients," Dr. Geier says. "Some surgeries have quicker turnarounds, and some surgeries don't do as well as others. For example, meniscal repairs are one of those procedures that are very difficult and the outcomes are not necessarily linked to poor quality. It's simply the nature of the injury."
4. Failure rates are not necessarily indicative of quality. Failure rates are defined by the rate at which patients fail to return to play due to a failed procedure. Dr. Geier says failure rates occur at a certain percentage for many procedures, including joint replacement procedures. While these rates should be closely followed and measured, Dr. Geier says failure rates are often out of the hands of sports medicine physicians and can be difficult to bring down to zero.
"Some of these sports medicine injuries, even with the best technique, rehabilitation and most compliant patient, can still fail," he says. "Yes, a complication can occur during or after a surgery, but that does not inherently imply that it was due to the surgeon's technique or quality of care."
In the same example Dr. Geier previously shared, meniscal repairs' failure rate could be associated with a large body of medical literature indicating poor blood supply in the meniscus. However, it is largely out of the sports medicine physicians' control to reverse the poor blood supply in efforts to maximize the outcomes of the surgery.
"[Improving failure rates] is the nature of sports medicine and all of medicine in general," Dr. Geier says. "In this field, we are doing everything we can to improve those failure rates and fighting to find new ways to repair injuries, whether through injecting platelet rich plasma to augment those repairs or altering rehabilitative techniques."
Learn more about Dr. David Geier.