TY - JOUR
T1 - Developing a NSQIP module to measure outcomes in children's surgical care
T2 - opportunity and challenge
AU - Dillon, Peter
AU - Hammermeister, Karl
AU - Morrato, Elaine
AU - Kempe, Allison
AU - Oldham, Keith
AU - Moss, Lawrence
AU - Marchildon, Michael
AU - Ziegler, Moritz
AU - Steeger, Janet
AU - Rowell, Kathy
AU - Shiloach, Mira
AU - Henderson, William
N1 - Funding Information:
The National Surgical Quality Improvement Programs (NSQIP) has been viewed as a highly successful quality improvement program. Originally developed for noncardiac surgical subspecialties in the Veterans Health Administration (VA), the applicability of the NSQIP concept to surgical care in the private sector was demonstrated through the Patient Safety in Surgery (PSS) study funded by a grant from the Agency for Health Care Research and Quality (AHRQ) to the American College of Surgeons (ACS). The success of the PSS study has led to NSQIP implementation in hospitals nationwide including academic health centers, large private institutions, and small community hospitals under the aegis of the ACS. However, the initial design of the PSS study was limited to adult general and vascular surgery. There is now a demand to extend the NSQIP to other surgical subspecialties and potentially broaden its utility. This manuscript details a proposal to develop an outcomes-driven quality improvement program for children’s surgery.
PY - 2008/5
Y1 - 2008/5
N2 - Under the guidance of the American College of Surgeons (ACS) and in partnership with the US Department of Veterans Affairs (VA), the National Surgical Quality Improvement Program (NSQIP) has been developed to improve the quality of surgical care in adults on a national level. Its purpose is to provide reliable, risk-adjusted outcomes data so that surgical quality can be assessed and compared between institutions. Data analysis consists of reporting observed to expected ratios (O/E) for 30-day postoperative mortality and morbidity measurements. A surgical clinical nurse reviewer is assigned at each medical center to collect information on 97 variables, including preoperative, operative, and postoperative factors for patients undergoing major operations in the specialties of general and vascular surgery. Eligible operations are entered into the database on a structured 8-day cycle to ensure representative sampling of cases. Since the introduction of the program into the VA system, there has been a 47% reduction in 30-day postoperative mortality and a 42% reduction in 30-day postoperative morbidity. Over 160 institutions have enrolled with the ACS in its adult NSQIP. In 2005, a planning committee was formed by the ACS and the American Pediatric Surgical Association to explore the development of a children's surgery NSQIP module. In conjunction with the Colorado Health Outcomes Program at the University of Colorado, a program potentially applicable to all children's surgical specialties has been designed. This manuscript describes the development of that Children's ACS-NSQIP module.
AB - Under the guidance of the American College of Surgeons (ACS) and in partnership with the US Department of Veterans Affairs (VA), the National Surgical Quality Improvement Program (NSQIP) has been developed to improve the quality of surgical care in adults on a national level. Its purpose is to provide reliable, risk-adjusted outcomes data so that surgical quality can be assessed and compared between institutions. Data analysis consists of reporting observed to expected ratios (O/E) for 30-day postoperative mortality and morbidity measurements. A surgical clinical nurse reviewer is assigned at each medical center to collect information on 97 variables, including preoperative, operative, and postoperative factors for patients undergoing major operations in the specialties of general and vascular surgery. Eligible operations are entered into the database on a structured 8-day cycle to ensure representative sampling of cases. Since the introduction of the program into the VA system, there has been a 47% reduction in 30-day postoperative mortality and a 42% reduction in 30-day postoperative morbidity. Over 160 institutions have enrolled with the ACS in its adult NSQIP. In 2005, a planning committee was formed by the ACS and the American Pediatric Surgical Association to explore the development of a children's surgery NSQIP module. In conjunction with the Colorado Health Outcomes Program at the University of Colorado, a program potentially applicable to all children's surgical specialties has been designed. This manuscript describes the development of that Children's ACS-NSQIP module.
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U2 - 10.1053/j.sempedsurg.2008.02.009
DO - 10.1053/j.sempedsurg.2008.02.009
M3 - Article
C2 - 18395663
AN - SCOPUS:41449117516
SN - 1055-8586
VL - 17
SP - 131
EP - 140
JO - Seminars in Pediatric Surgery
JF - Seminars in Pediatric Surgery
IS - 2
ER -