| Use of national surgical quality improvement program data as a catalyst for quality improvement. | |
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MedLine Citation:
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PMID: 17544087 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Semiannually, the National Surgical Quality Improvement Program (NSQIP) provides its participating sites with observed-to-expected (O/E) ratios for 30-day postoperative mortality and morbidity. At each reporting period, there is typically a small group of hospitals with statistically significantly high O/E ratios, meaning that their patients have experienced more adverse events than would be expected on the basis of the population characteristics. An important issue is to determine which actions a surgical service should take in the presence of a high O/E ratio. STUDY DESIGN: This article reviews case studies of how some of the Department of Veterans Affairs and private-sector NSQIP participating sites used the clinically rich NSQIP database for local quality improvement efforts. Data on postoperative adverse events before and after these local quality improvement efforts are presented. RESULTS: After local quality improvement efforts, wound complication rates were reduced at the Salt Lake City Veterans Affairs medical center by 47%, surgical site infections in patients undergoing intraabdominal surgery were reduced at the University of Virginia by 36%, and urinary tract infections in vascular patients were reduced at the Massachusetts General Hospital by 74%. At some sites participating in the NSQIP, notably the Massachusetts General Hospital and the University of Virginia, the NSQIP has served as the basis for surgical service-wide outcomes research and quality improvement programs. CONCLUSIONS: The NSQIP not only provides participating sites with risk-adjusted surgical mortality and morbidity outcomes semiannually, but the clinically rich NSQIP database can also serve as a catalyst for local quality improvement programs to significantly reduce postoperative adverse event rates. |
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Authors:
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Katherine S Rowell; Florence E Turrentine; Matthew M Hutter; Shukri F Khuri; William G Henderson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: 204 ISSN: 1072-7515 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-06-04 Completed Date: 2007-07-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1293-300 Citation Subset: AIM; IM |
Affiliation:
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QCMetrix, Inc, Waltham, MA 02451, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Hospitals, Veterans Humans Postoperative Complications Private Sector Quality Indicators, Health Care Quality of Health Care* Surgical Procedures, Operative / mortality, standards* United States United States Department of Veterans Affairs |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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