A structured framework for optimizing surgical quality through process-of-care trials

Increased national focus has been placed on care delivery processes and their effect on health care quality. At the institutional level, investigators are increasingly engaged in surgical process-of-care trials that, compared to traditional randomized treatment trials, more explicitly control and mitigate provider- and system-based risk. Process-of-care trials have the potential to improve patient care while also improving the culture of a surgical department, hospital, and system.