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Quality and Safety

The University of Michigan multidisciplinary pancreas program treats many patients each year with pancreatic disease, including pancreatic cancer. Surgeons, medical oncologists, radiation oncologists, gastroenterologists, pathologists, and radiologists who specialize in the care of patients with pancreatic disease work together to evaluate every patient, and to derive the best possible strategy for an individual patient's care.

The following information focuses on surgical treatment, and the graphs demonstrate that Michigan Medicine has considerable experience in performing pancreatic surgery with excellent outcomes when compared to peer institutions.

Procedure Volumes

Procedure volume is the number of times a procedure was performed in a year. This measure is often used to assess experience and expertise of both the surgeon and the team caring for the patient. Studies have linked higher volumes with more successful outcomes for some types of procedures, including pancreatectomy. The following graphs compare the total number of major pancreatic operations performed at Michigan Medicine to the average number performed at 28 hospitals from the University Health System Consortium (UHC) that are similar to our own hospital.

distal pancreatectomy case volume graph shows  U-M does more cases than average

Distal pancreatectomy Case Volume

This is a measure of the volume, or number of distal pancreatic operations performed. Distal pancreatectomy refers to removing the tail and possibly body of the pancreas. It is important to consider both volume and outcome measures when assessing quality of care.

How is Michigan Medicine Performing?
Surgeons at the University of Michigan perform a substantial and increasing number of complex pancreatic operations each year. Our surgeons have considerable experience and our program is growing.

 

Proximal Pancreatectomy [Whipple Procedure] Case Volume graph shows U-M does more cases than average, but the volume has been decreasing

Proximal Pancreatectomy [Whipple Procedure] Case Volume

This is a measure of the volume, or number of proximal pancreatectomies or Whipple procedures performed. Proximal pancreatectomy or Whipple procedure involves removing the head and neck of the pancreas along with the common bile duct and the duodenum (first part of the small intestine). It is important to consider both volume and outcome measures when assessing quality of care.

How is Michigan Medicine Performing?
Surgeons at the University of Michigan perform a substantial number of Whipple procedures each year. Our surgeons have considerable experience.

 

Total Case Volume graph shows U-M does many more cases than average

Total Case Volume

This is a measure of the volume, or number of total pancreatectomy operations performed. Total pancreatectomy combines distal and proximal pancreatectomies and means removing the entire pancreas. It is important to consider both volume and outcome measures when assessing quality of care.

How is Michigan Medicine Performing?
Surgeons at the University of Michigan perform an increasing number of complex pancreatic operations each year. Our surgeons have considerable experience and our program is growing.

 

 

Outcomes

Outcomes evaluate the quality of care for patients undergoing pancreatectomy by measuring mortality rates and the occurrence of complications after surgery. We measure the use of intensive care services after surgery and re-hospitalization rates as a means to estimate the occurrence of complications. The following graphs compare our performance to the average for 28 hospitals from the University Health System Consortium (UHC), that are similar to our own hospital.In all of these graphs, a lower percentage means better performance. The graphs show that our complication and mortality rates are often lower than the average for the selected UHC hospitals.

There is a very low risk of mortality for distal pancreatectomy

Distal Pancreatectomy Mortality Rate

Pancreatectomy is a relatively high risk operation. As with other outcome measures reported here, mortality after a pancreatectomy is often a reflection of how well the patient has been prepared for the operation, the skill of the surgeon, and the expertise of the team caring for the patient in the hospital. This is a measure of the percentage of patients who died after undergoing a pancreatectomy. For this measure, a lower percentage means better performance.

How is Michigan Medicine Performing?
At the University of Michigan, distal pancreatectomy patients fare better than the averages for 28 similar hospitals which are members of the University Health System Consortium.

 

The length of stay for this procedure is a little over 8 days

Distal Pancreatectomy Length of Stay

This measure is defined as the average time in days a patient is in the hospital when having this procedure. For this measure, a lower average length of stay combined with a lower rate of re-hospitalization (Re-admission) means better and more efficient performance.

How is Michigan Medicine Performing?
The University of Michigan typically has similar lengths of stay on average for patients undergoing distal pancreatectomy than the average at 28 similar hospitals which are members of the University Health System Consortium.

 

The mortality rate for the whipple procedure at the U-M is zero

Proximal Pancreatectomy [Whipple Procedure] Mortality Rate

Proximal pancreatectomy (Whipple) is a high risk operation. As with other outcome measures reported here, mortality after a pancreatectomy is often a reflection of how well the patient has been prepared for the operation, the underlying medical condition of the patient, the impact of other cancer therapies before surgery, the skill of the surgeon, and the expertise of the team caring for the patient in the hospital. This is a measure of the percentage of patients who died after undergoing a proximal pancreatectomy.

How is Michigan Medicine Performing?
At the University of Michigan, proximal pancreatectomy patients have a similar mortality rate compared to the averages for 28 similar hospitals which are members of the University Health System Consortium. The University of Michigan Pancreas program has demonstrated a consistent low mortality rate of 0-3.4% following proximal pancreatectomy despite performing these operations on patients with increasingly advanced disease and requiring vascular reconstruction (repairing the blood supply vessels) performed at the time of Whipple procedure. As we continuously monitor and strive to improve our quality and outcomes we hope to bring this mortality rate to <1% in the near future even in this complex patient population.

 

The length of stay for the whipple procedure at the U-M is slightly higher than average, at 12 days

Proximal Pancreatectomy [Whipple Procedure] Length of Stay

This measure is defined as the average time in days a patient is in the hospital when having this procedure. For this measure, a lower average length of stay combined with a lower rate of re-hospitalization (Re-admission) means better and more efficient performance.

How is Michigan Medicine Performing?
The University of Michigan consistently has similar or shorter lengths of stay on average for patients undergoing proximal pancreatectomy (Whipple Procedures) when compared to the average at 28 similar hospitals which are members of the University Health System Consortium.

 

Please visit the Pancreatic Surgery Quality and Safety page for more information about readmission rates, ICU cases and other quality indicators.

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