Reliability of Reliability Adjustment for Quality Improvement and Value-based Payment.

Anesthesiology, V 124 • No 1 16 January 2016 R ECENT work has demonstrated the importance of “reliability adjustment” when comparing surgical performance across hospitals.1,2 Reliability adjustment is a technique that most anesthesiologists have never heard of, but nearly all anesthesiologists are ranked using it because of its widespread adoption by nearly all programs that measure surgical outcomes including the Society of Thoracic Surgeons, the American College of Surgeons National Surgical Quality Improvement Program, the Scientific Registry of Transplant Recipients, and the Center for Medicare and Medicaid Services. Here, we describe the technique, why it is useful and why it merits scrutiny by anesthesiologists engaging in quality improvement and public reporting programs.