Improving practice and patient care in OMFS

This page is aimed at OMF surgeons and other health care professionals interested in the QOMS project.  A similar page for patients and members of the public interested is available here.

QOMS Reports 

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What is QOMS?

Escalating healthcare expenditure in the NHS is unsustainable, and service commissioners need to provide cost-effective surgical procedures that demonstrate clear health benefits in line with best evidence-based practice. Patients should expect, and demand, high quality care and the best possible surgical outcomes from oral and maxillofacial surgery (OMFS), but the specialty lags behind other surgical specialties in publication of clinical outcomes across the UK (McMahon et al. 2018, Ho et al. 2021).

In November 2018, the Get It Right first Time (GIRFT) initiative published their first report for the oral and maxillofacial surgery. The report highlighted the lack of systematic clinical outcome measures in place, thus limiting opportunities for the specialty:

• To understand if care was being delivered in line with standards
• For providers to benchmark themselves against others
• To support continuous improvement.

Recommendation 5 of the GIRFT report was to "Deliver an efficient and patient-focused outcomes audit programme for oral and maxillofacial surgery”.

BAOMS, under its 2018 President Mr Ian Martin, and with the support of Council, initiated a specialty-wide quality improvement and clinical effectiveness programme, the Quality and Outcomes in oral and Maxillofacial Surgery (QOMS) Project. This reflected the President’s view that implementing systematic quality improvement in OMFS and ensuring effectiveness of care provided based upon appropriate metrics were key to the continued successful development of surgical care in the NHS and reflected the core culture of the Association.

QOMS is the quality improvement and clinical effectiveness programme for OMFS.

To meet the needs of the specialty, QOMS developed a series of registries to address issues around quality of care and improvement, and clinical effectiveness. The Subspecialty Interest Groups and the membership were consulted to decide on the procedures, conditions and the quality-of-care indicators to be included in QOMS.

Data collection and storage is managed by the Barts Cancer Research-UK Centre at Queen Mary University of London (BCC, QMUL), using the Research Electronic Data Capture software (REDCap). 

• Watch our introductory videos 
• Meet the team 

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QOMS aims

To set up and develop a sustainable quality management and clinical effectiveness programme that delivers continuous improvement in the care of patients undergoing OMFS, within all parts of the NHS and demonstrates health-related benefits to patients from selected core OMFS activities.

QOMS has set up and operates a series of clinical registries to collect data about OMFS practices in the UK and in time the Republic of Ireland. They were developed for either quality improvement (audits or service evaluations) or clinical effectiveness and surveillance (disease- and procedure-specific registries). QOMS exists in parallel to other already existing registries and quality improvement initiatives (see below).

Figure 1. Roles of clinical registries

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QOMS Audit activities

Data collected in QOMS will be used to compare OMFS units across the UK and identify and share best care practices. The project focuses on areas of the care process that impact on OMFS surgical teams.

Figure 2. Use of clinical registries for audit and quality improvement activities

QOMS wants to identify best performers against any given metric across the NHS, quality assure that data, and then generalise the care practices that underpin it by case studies, newsletters, presentations at conference, as well as BAOMS website content. Where performance falls significantly below the mean, and data checking confirms that to be the case, the association intends to provide mentorship for change.

See QOMS Audit registries for more information 

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QOMS Registry activities

While audit activities mainly concentrate on the lower part of the clinical registry cycle, QOMS aims to also develop in time some disease- or procedure-specific registries. Those registries will be used to assess the long-term effects and the changes of current practices on care quality and patient’s outcomes and look at OMFS practice for which there is little or no strong available evidence and support the development of for high-quality, strong recommendations.

 Figure 3. Use of clinical registries for clinical effectiveness, disease- and procedure-specific registries

See the Condition and procedure-specific registries page for more information. 

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Other National Registries and quality improvement initiatives

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QOMS structure and organisation

QOMS is overseen by the BAOMS Council and the QOMS Steering Committee. The QOMS team is led by the BAOMS QOMS Clinical Lead, Mr Michael Ho, and deputy lead, Mr David Tighe. The QOMS Project manager, Dr Fabien Puglia, is responsible for the day-to-day activities of the project.

The project team also include:

• The Information Governance Group (IGG), which deals with all information governance issues. The IGG includes Mr Michael Ho, Mr Jeremy McMahon (Caldicott Guardian), Dr Marisa Mason (National Confidential Enquiry into Patient Death and Outcome, NCEPOD) and Dr Fabien Puglia.
• The Audit and Registry working groups (see individual registry’s descriptions): Mr Geoff Chiu, Mr Panayiotis Kyzas, Professor Ashraf Ayoub, Mr Moorthy Halsnad, Ms Christine Lwin, and Mr Alexander Hills.
• Trainee representative: Ms Harmony Ubhi.
• A Patient and Public Involvement group made up by patients and lay members to represent the opinions and voices of patients from different subspecialties.    
• QOMS is also supported by members of Saving Faces: Professor Iain Hutchison and Dr Fran Ridout.

Figure 4. Structure of the QOMS project

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Other media

• QOMS short protocol (to be updated)
• How to register to REDCap (contact Fabien)
• How to use REDCap (to be updated)
• QOMS Privacy and Fair processing notice 
• Patient leaflets and Department Posters

Important links:

• QOMS LIVE REDCap database - where real data is entered
• QOMS TEST database - to explore the system
• Forgotten password? Account locked? Visit the BCC Password Selfservice (see instructions above).
• For any other problems, contact Fabien Puglia
• X: @BAOMSOfficial
• LinkedIn: baoms

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Last updated: February 2024