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Regional surgical quality collaborative improves outcomes, reduces cost

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A study published in the Journal of the American College of Surgeons has found hospitals that participated in a regional collaborative of the American College of Surgeons National Surgical Quality Improvement Program achieved improvements in surgical outcomes and saved almost $2.2 million per 10,000 general and vascular surgery cases in 2010.

Rates of surgical site infection and acute renal failure were reduced in the participant hospitals, according to an American College of Surgeons news release. The release reported the Tennessee Surgical Quality Collaborative (TSQC) collected American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data from 10 participating hospitals, evaluating 20 categories of postoperative complications, 30-day mortality rates and hospital costs associated with postoperative complications in a total of 14,205 surgical cases in 2009 and 14,901 surgical cases in 2010.

"We demonstrated that hospitals in a collaborative can greatly improve their quality by sharing data, comparing results and evaluating best practices and process improvement approaches with their peers," study author Joseph B. Cofer, MD, FACS, stated in the release.

According to the results, the Tennessee collaborative found improvements in superficial site infection (18.9% reduction), graft, prosthesis and flap failure (60.5% reduction), acute renal failure procedures (25.1% reduction), wound disruption (34.3% reduction) and ventilator time greater than 48 hours (14.7% reduction). The improvements led to a net savings of nearly $2.2 million per 10,000 general and vascular procedures.

The release noted that ACS NSQIP collects only a sample of cases, thus 10,000 cases represents only around a fourth of the total general and vascular surgery cases handled in TSQC hospitals in 2009 and 2010.

According to the researchers, improvements in areas such as skin and soft tissue or wound disruption and ventilator management may be credited to the identification of a problem and change in practice based upon evidence-based medicine.

Reference:

• Guillamondegui OD, Gunter OL, Hines L, et al. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to improve surgical outcomes. J Am Coll Surg. 2011. doi: 10.1016/j.jamcollsurg.2011.12.012.

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