The VA Outcomes Group and the Quality Scholars Program at Dartmouth led by John Birkmeyer, MD, have undertaken a review of unplanned returns to the operating room following a series of general surgery cases. The purpose of their presentation is the utilization of these data as a means of assessing the quality of a general surgery service.

While the hypothesis is a commendable one, there are many reasons why patients may require reoperation following initial procedures. Although technical error is certainly one of these reasons, many patient- and hospital-related factors are difficult to quantify in terms of their contribution to untoward patient outcomes (ie, type of hospital, presence of house staff and medical students, criteria for reoperation as opposed to nonoperative approaches . . . [Full Text of this Article]