Departmental News

DEPARTMENT ENROLLED IN NATIONAL AMERICAN COLLEGE OF SURGEONS QUALITY IMPROVEMENT PROGRAM: Participating Centers Have Improved Health Outcomes and Increased Patient Satisfaction

In February 2006, University Hospital became a participating center in a national surgical quality improvement program of the American College of Surgeons. This program, called the National Surgical Quality Improvement Program (NSQIP), has an impressive record of substantially reducing morbidity and mortality and increasing patient satisfaction.

The NSQIP is the first nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care. It is designed to help clinical surgery departments collect and analyze risk-adjusted surgical outcomes data in order to develop clinical performance improvement initiatives. In 2002, the Institute of Medicine named the NSQIP “the best in the nation” for measuring and reporting surgical quality and outcomes.

Medical centers participating in the NSQIP have improved health outcomes, reduced postoperative lengths of stay and hospital costs, and increased patient satisfaction.

“Our participation in this program will help us to identify and reduce factors associated with post-op complications,” says John J. Ricotta, MD, professor and chairman of surgery. “It will help us to continually improve our performance and outcomes. It will also give us a great teaching tool for both residents and faculty. And what we learn should greatly benefit our patients here.”

The program employs a prospective, peer controlled, validated database to quantify 30-day risk-adjusted surgical outcomes, which allows valid comparison of outcomes among all hospitals in the program. Medical centers and their surgical staff are able to use the data to make informed decisions regarding their continuous quality improvement efforts.

The data collection at Stony Brook is conducted by a surgical clinical nurse reviewer, trained by NSQIP personnel, who records and reports 30-day morbidity and mortality outcomes for selected major inpatient and outpatient surgical procedures in general and vascular surgery. For each surgical case, this reviewer collects data on a host of variables, including demographic, preoperative, intraoperative, and postoperative data.

Data are then reported daily online, and in ad-hoc, semiannual, and annual reports. Findings from the reports will provide the foundation for quality improvement action plans.

As evidence of the NSQIP’s effectiveness, the U.S. Department of Veterans Affairs from 1991 to 2001 experienced a 27% decline in postoperative mortality and a 45% drop in postoperative morbidity through participation in the program. Not only that, median postoperative length of stay fell from nine to four days, and not surprisingly, patient satisfaction improved.

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