A Comprehensive Patient Registry at the Neurosurgery Department

Aim: Patient registries are an important tool to document clinical practice. In addition, registries may influence clinical practice in that they demand rigorous documentation and standard operational procedures. In view of the growing need to document the highly specialized treatments provided in our department, we have started a patient registry to register all patients operated upon in the neurosurgery department of the University Hospital Zürich. Methods: The patient inclusion started on January 1, 2013. Surgeries were characterized by indication, treatment, and other specific neurosurgical parameters. Preoperative state and postoperative outcome are recorded prospectively with neurological and sociological scales. Results: Data acquisition compatible with the clinic workflow permits to include all eligible patients into the registry. Up to now we have registered >2,300 surgeries and 4,000 consultations. Ongoing evaluation is performed in cooperation with the specialized teams treating the six main indications: neurooncology, neurovascular diseases, functional neurosurgery, neuroendocrine disorders, CSF disorders, and trauma. Results are presented to the whole department on a regular basis. Conclusions: Maintaining a registry is feasible if sufficient manpower is provided. The registry serves to streamline and to complete information flow in the clinic, to identify complication rates and trends early for the internal quality monitoring, and to distinguish outliers and rare events. While the introduction of DRG aims at cost transparency, the patient registry provides outcome transparency.