Standards of surgery beyond metropolitan centers: a fresh look at perioperative quality measures in small-town America.

Background: Surgical quality measures have room for improvement in both large- and small-town hospitals.

Methods: We sought concurrence of surgical specialists (general, orthopedic, gynecologic) to study accepted quality and safety parameters using a surgical time-out-based platform.

Results: Surgeons and hospitalists participated promptly and actively and recorded enhanced performance measures compared with prior work and within the period of study.