The Department of Veterans Affairs (VA) was mandated by the congress to report all surgical outcomes. This led to the adopting of National surgical Quality Improvement Program (NSQIP) by senior surgeon. The senior surgeons had realized they needed improvement after seeing complications caused by infections, blood clots, respiratory failure, etc. These complications increased length of hospital stays, death, and the costs were unbearable. The change was made fruitful by having surgeons aboard.
The NSQIP program was created to provide reliable, valid, and comparative information about surgical outcomes across 123VAMCs performing major surgery. The data collected and reported include preoperative patient risk factors, key intraoperative process information, postoperative 30-day mortality and morbidity rates, and length of stay. The mortality and morbidity rates are risk ...view middle of the document...
The higher performing surgical performers used protocols and best practice guidelines more often than surgical services with worse-than-expected outcomes. The higher performing surgical performers also received higher patient satisfaction scores.
The success of VAMC’s quality improvement is attributed to the efforts of its physician driven and executive leadership support. The most important is their Information technology infrastructure, the VA’s progressive VISTA system. It has managed to centralize storage of data from across their 123 participating VAMC centers.
The VA’s validation study, conducted between 1991 and 1993, found that its methods for risk-adjusting outcomes accurately predict quality of care structures and processes. During the first nine years of data collection, the VA NA NSQIP documented a 27% reduction in 30 day postoperative mortality and a 45% reduction in 30 day postoperative morbidity for noncardiac surgery performed at 128 VA hospitals. The most interesting thing is that the 14 participating hospitals achieved a significant reduction in surgical complications during the 3 year study period. (www.commonwealthfund.org).
The ongoing practices were controlled by collecting clinical meaningful data, standardized outcome definitions, and a validated risk-adjustment mechanism. The best of all is their surgeon led committee, and the interdisciplinary team work. One thing I have realized when I was reading about this facility, was the seriousness of each discipline. It was interesting to note that those who were lacking in team work were labeled as “lower performing”.
Case Study: The National Surgical Quality Improvement Program. (2008). Retrieved from http://www.commonwealthfund.org/Innovations/Case-Studies/2008/June/Case-Study--The...
Bell, M.J., Weaver, C. A., Kiel, J.M., (Eds.), Healthcare Information Management Sysytems:Cases, Strategies,and Solutions (pp. 277-279). New York:Spinger-Verlag.