Measuring Quality of Surgical Care to drive Quality Improvement
The Center for Surgery and Public Health (CSPH) is dedicated to the mission of measuring surgical outcomes and improving the quality of surgical care. One approach to meet this objective is thru participation with The American College of Surgeons National Surgical Quality Improvement Program (ACSNSQIP). ACSNSQIP is the first nationally validated, risk adjusted, outcomes-based program to measure and improve the quality of surgical care. 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. The Center for Surgery and Public Health of the Brigham and Women’s Hospital has participated in ACSNSQIP since 2002.
A trained Registered Nurse reviewer collects data for randomized patients undergoing major general and vascular surgical procedures in both the inpatient and outpatient settings. The data collected includes 133 variables, including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes. Using stepwise logistic regression, risk-adjusted 30-day morbidity and mortality are computed for each participating hospital. Outcomes are reported as observed versus expected ratios and are distributed in a semiannual report. Data can also be gathered thru real-time, continuously updated, online benchmarking reports. This data provides CSPH with a method of evaluating current surgical outcome trends within our hospital and with other participating hospitals. Furthermore, this data are utilized to create improvement in the quality of surgical care.
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