Reflection statement for participants in this CME activity:

“Comparison of Robotic and Laparoscopic Colectomies Using the 2019 ACS NSQIP Database” by Nemeth et al in this month’s Southern Medical Journal used the NSQIP database of the American College of Surgeons to study surgical complications associated with robotic and conventional laparoscopic colectomies when used for patients with colon cancer or chronic diverticulitis.

This article is an example of how a national database can provide data to drive process and quality improvement efforts. This article summarizes data from a nation-wide database that identifies non-equivalence of conventional versus robotic assisted laparoscopy with respect to a few different surgical complications.

Whether the types and rates of the complications in the database for conventional and robot-assisted laparoscopic colectomies performed to treat chronic diverticulitis or colon cancer reflect the experience of a specific organization or a specific surgeon will take some additional effort to obtain and analyze local data. The findings of this study suggest that such further efforts to measure local performance may be worthwhile.

If local performance is similar to or worse than the national database data reported in this article then local interventions to achieve quality improvement should be considered and monitored to assure they are effective and to allow further process improvement over time.

If local experience is superior to the findings in the national database then local practice can be continued as long as it outperforms the findings reported in the national database. Consideration can be given to identifying key performance metrics and monitoring these metrics serially to trigger and guide continuous quality improvement efforts when indicators show performance that warrants improvement.