Identifying critical quality metrics in Mohs Surgery: A national expert consensus process

Joseph A. Dodson, Sarah A. Ibrahim, Howard Rogers, M. Laurin Council, Kishwer S. Nehal, Rebecca Tung, David J. Leffell, Nathalie C. Zeitouni, Mariam B. Totonchy, Scott W. Fosko, Seaver Lee Soon, Travis W. Blalock, David G. Brodland, Elizabeth M. Billingsley, Jeffrey F. Scott, Brian C. Leach, Desiree Ratner, Carl Washington, C. William Hanke, Clark C. OtleyNicholas Golda, Rajiv I. Nijhawan, Jerry Brewer, Addison Demer, Frederick Fish, Christopher B. Harmon, John Zitelli, Thomas Knackstedt, Gaurav Singh, Todd Mollet, David R. Carr, John G. Albertini, Brent R. Moody, Michel McDonald, Jeremy S. Bordeaux, Paul R. Massey, Mollie A. MacCormack, Allison Vidimos, Christopher J. Arpey, Sarah T. Arron, Omar A. Ibrahimi, S. Brian Jiang, Christopher J. Miller, Ian A. Maher, Ashley Wysong, Barry Leshin, Glenn D. Goldman, Nour Kibbi, Hao Feng, Lindsey Collins

Research output: Contribution to journalArticlepeer-review


Background: Amid a movement toward value-based healthcare, increasing emphasis has been placed on outcomes and cost of medical services. To define and demonstrate the quality of services provided by Mohs surgeons, it is important to identify and understand the key aspects of Mohs micrographic surgery (MMS) that contribute to excellence in patient care. Objective: The purpose of this study is to develop and identify a comprehensive list of metrics in an initial effort to define excellence in MMS. Methods: Mohs surgeons participated in a modified Delphi process to reach a consensus on a list of metrics. Patients were administered surveys to gather patient perspectives. Results: Twenty-four of the original 66 metrics met final inclusion criteria. Broad support for the initiative was obtained through physician feedback. Limitations: Limitations of this study include attrition bias across survey rounds and participation at the consensus meeting. Furthermore, the list of metrics is based on expert consensus instead of quality evidence-based outcomes. Conclusion: With the goal of identifying metrics that demonstrate excellence in performance of MMS, this initial effort has shown that Mohs surgeons and patients have unique perspectives and can be engaged in a data-driven approach to help define excellence in the field of MMS.

Original languageEnglish
Pages (from-to)798-805
Number of pages8
JournalJournal of the American Academy of Dermatology
Issue number4
StatePublished - Apr 2024


  • ACMS
  • American College of Mohs Surgery
  • Mohs surgery
  • quality metrics
  • value-based healthcare


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