Lessons learnt from the construction and implementation of a prospective ventral hernia database

The New England VA Hernia Registry was created in 2011 to prospectively collect relevant details of ventral hernia repairs, with the intention to assess and improve long term outcomes. The goal of this study is to assess registry compliance.

All ventral hernia operations performed in five VA hospitals between 2011–2022 were obtained. We assessed compliance at the hospital and surgeon level.

3,516 cases were performed. Overall compliance with registry entry was 37.5%, ranging from 10.8% to 67.2% across hospitals. At the hospital level, there was a negative correlation between average yearly hernia volume per surgeon and registry compliance (r² = 0.53). Surgeon compliance varied within hospitals and over time.

Registry compliance was low and highly variable. Lack of interest, incentives, oversight, and surgeon turnover are possible factors for noncompliance. Building a registry with these factors in mind, providing timely feedback, and conducting frequent audits may improve compliance.