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“Early in my career, I was encouraged to take a course on quality as it

relates to medical outcomes, and my interest in the idea of quality has only

grown since then,” said John Joseph “Jack” Knightly, MD, FAANS. “When

NeuroPoint Alliance (NPA) was formed it seemed like the right venue for

neurosurgeons: NPA, through the National Neurosurgical Quality Outcomes

Database (N


QOD), provides us a platform to collect clinical data proving

what we do, as neurosurgeons, is beneficial for our patients’ quality of life.

“Why is real data so important? The popular press cycles through ‘spine

surgery doesn’t work’ stories with frightening regularity. The real truth about

the majority of spinal surgical procedures is glossed over as an ’inconvenient

truth.’ Surgically, when done on the right patient at the right time for the

right procedure, we are improving patients’ quality of life in the majority

of cases. As individual surgeons, working with our own patients, we know

this. We see what we can do for our patients. The power of NPA is that

we, as a collective of surgeons, can aggregate information about surgeries

and outcomes all across the country. This allows us to empirically prove our

procedures work out there in the real world.

“Beyond showing the success, the data shows us where we need to improve.

We can benchmark how we do at an individual, group or hospital level.

Benchmarking to a norm shows the opportunities for improvement.

“The other side of this equation is what the data means to our patients.

I find that when patients participate in decision-making regarding their

treatment, we see a better clinical result. Accurate patient outcome

percentages is the goal. With 16,000 patients already in the lumbar module,

we can create a tool that allows me, as a surgeon, to sit with a patient,

review the data that matches his or her profile and manage expectations.”

Ralph Bobroski has been Knightly’s patient twice and is part of the NPA patient

outcome registry. Bobroski revealed, “I was more than comfortable going back

to see Dr. Knightly when I needed a second surgery. He is very patient. He has

a really great rapport with patients. I’ve been very pleased with my results and

I’ll continue to recommend him to family and friends. The seven years between

my surgeries made for two very different kinds of recoveries; I hadn’t realized

what a difference I’d see in recovery having aged from 64 to 71.”

“As powerful as the patient tool will be at an individual level, helping patients

like Mr. Bobroski understand outcomes before experiencing outcomes, it will be

even more powerful with regard to the profession. N


QOD will help with the

new reality of medicine, managing experiences and costs,” added Knightly.

“I think we are moving from today’s pay-for-procedure model to a pay-for-

performance reality,” he continued. “Because of this, I liked helping to write

neurosurgery’s own report card, which was successfully submitted to CMS

Physician Quality Reporting System (PQRS). Working with NPA to generate

the first neurosurgery-specific reporting measures has been an objective,

thoughtful and collaborative process. The data we collect through the NPA

registries meets Qualified Clinical Data Registry (QCDR) requirements and is

meaningful for neurosurgeons and our patients.”

Another registry patient, Joanne Matina, had surgery at the age of 76 to

address chronic and near debilitating back pain. She celebrated four months

post-surgery by purchasing a trike motorcycle. “Dr. Knightly is the reason I’m

on a motorcycle, even though he made me wait a few more months than I

thought I needed. He relieves so much pain for people. Unless you’ve lived

with that kind of chronic pain, I don’t think you can really understand what it

means to have it go away,” said Matina.

Knightly, while pleased that Matina got the results they both hoped for, is

less than pleased with her latest purchase.

John Joseph “Jack” Knightly, MD, FAANS

, received his Bachelor of Arts from Franklin

and Marshall College, Lancaster, Pa., and his medical degree from The University of

Medicine and Dentistry of New Jersey, Newark, N.J. He completed his post-graduate

training and residency training at the Bethesda Naval Hospital, Bethesda, Md. Dr.

Knightly completed a research fellowship in the surgical neurology branch of the

National Institutes of Health and in pediatric neurosurgery at The Children’s Hospital

in Boston. He completed advanced training in trauma at the Shock-Trauma Center

in Baltimore. In addition, Dr. Knightly completed a fellowship in complex spine with

Volker Sonntag, MD, FAANS(L), at The Barrow Neurological Institute in Phoenix. He is

the director of neurosurgery at Morristown Memorial Hospital and the vice-chairman

of Atlantic Health Institute in Morristown, N.J., where he also serves as the medical

director of the neuro-spine team.

Driving Data, Improving Neurosurgery

John Joseph “Jack” Knightly, MD, FAANS