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Hernia. 2016 Apr;20(2):177-89. doi: 10.1007/s10029-016-1477-7. Epub 2016 Mar 2.

Design and implementation of the Americas Hernia Society Quality Collaborative (AHSQC): improving value in hernia care.

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Department of Surgery, Vanderbilt University Medical Center, D-5203 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232, USA.
Division of General Surgery, Santa Casa of Sao Paulo Medical School, Rua Mato Grosso 306-CJ 408, Sao Paulo, 01239-040, Brazil.
William Beaumont Hospital-Troy, 44199 Dequindre, Troy, MI, 48085-1128, USA.
Carolinas Medical Center, 1000 Blythe Blvd, 2nd Fl Administrative Suites, Charlotte, NC, 28203, USA.
Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive #300, Charlotte, NC, 28204, USA.
Mid-South Center for Minimally Invasive Surgery, University of Tennessee Health Sciences Center, 7945 Wolf River Boulevard, Suite 200, Germantown, TN, 38138, USA.
New Hanover Regional Medical Center, 2131 S. 17th Street, PO Box 9025, Wilmington, NC, 28401, USA.
Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA.
Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756-0001, USA.
The Cleveland Clinic, 9500 Euclid Avenue/A100, Cleveland, OH, 44195, USA.



Wide variation in care and costs exists regarding the management of abdominal wall hernias, with unproven benefit for many therapies. This work establishes a specialty society-based solution to improve the quality and value of care delivered to hernia patients during routine clinical management on a national scale.


The Americas Hernia Society Quality Task Force was charged by the Americas Hernia Society leadership to develop an initiative that utilizes the concepts of continuous quality improvement (CQI). A disease-based registry was created to collect information for CQI incorporating real-time outcome reporting, patient reported outcomes, stakeholder engagement, and collaborative learning methods to form a comprehensive quality improvement effort.


The Americas Hernia Society Quality Collaborative (AHSQC) was formed with the mission to provide health care professionals real-time information for maximizing value in hernia care. The initial disease areas selected for CQI were incisional and parastomal hernias with ten priorities encompassing the spectrum of care. A prospective registry was created with real-time analytic feedback to surgeons. A data assurance process was implemented to ensure maximal data quality and completeness. Four collaborative meetings per year were established to meet the goals of the AHSQC. As of the fourth quarter 2014, the AHSQC includes nearly 2377 patients at 38 institutions with 82 participating surgeons.


The AHSQC has been established as a quality improvement initiative utilizing concepts of CQI. This ongoing effort will continually refine its scope and goals based on stakeholder input to improve care delivered to hernia patients.


AHSQC; Abdominal wall reconstruction; Hernia; Quality

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