 |
|
|||||||
|
|
|
|
|
|
|
|
|
|||||||
 |
|
ACS Outcomes DatabasesGeneral Overview: As the health care community continues to move toward evidence-based medicine and accountability through patient outcomes, the Division of Research and Optimal Patient Care (DROPC) continues to provide surgeons with the resources needed to measure their outcomes. The DROPC encompasses three areas including the area of Continuous Quality Improvement (CQI), Trauma, and Cancer. There are programs and related databases within each of these areas that focus on patient outcomes and quality improvement. Trauma and Cancer oversee the National Trauma Data Bank (1.5 million records) and the National Cancer Database (over 18 million records) respectively. Each database contains the largest collection of patient data for their respective areas and serves as a deep reservoir for researchers interested in clinical trials and outcomes research. Links to pages that contain information on these databases are provided below. Continuous Quality Improvement is responsible for the ACS National Surgical Quality Improvement Program (ACS NSQIP). The ACS NSQIP is a risk-adjusted, outcomes-based program to measure and improve the quality of surgical care. CQI is responsible for the fiscal management and operations of the program, regulatory compliance, and oversight of the data for research projects and publications. In addition, CQI staff ensures the program follows the Advisory Committee’s guidance. A brief overview of the ACS NSQIP can be found below and complete information as well as an online application to the program can be found on the ACS NSQIP Web site at http://www.acsnsqip.org/. American College of Surgeons National Surgical Quality Improvement Program The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) 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, which allows valid comparison of outcomes among all hospitals in the program and provides participants with the tools, reports, analysis, and support necessary to make informed decisions about improving quality of care. ACS NSQIP is available to all eligible hospitals in the United States that meet the minimum volume requirements, complete a hospital participation agreement, and assign staff to the program. Eleven years ago the Veterans Health Administration (VHA) created the NSQIP to measure operative morbidity and mortality in VHA Hospitals. After implementing the program in 128 hospitals, surgical mortality decreased 27% and morbidity decreased 45%. In 2001, a collaboration of the VHA and the ACS resulted in a grant from the Agency for Healthcare Research and Quality (AHRQ) to implement the NSQIP in private sector hospitals. Over the course of the three-year study, more than 100,000 surgical cases were collected from 18 private hospitals. The study results showed that the program was successfully implemented and the NSQIP methodology works well in the private sector. In October of 2002, the Institute of Medicine named the NSQIP the “best in the nation” for measuring and reporting surgical quality and outcomes. A main strength of the ACS NSQIP is the priority it places on the data collection process. Each participating hospital is required to hire a dedicated Surgical Clinical Nurse Reviewer (SCNR). This person is trained by ACS NSQIP to collect and enter data on 133 variables, including pre-operative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. The data are submitted to ACS NSQIP through a secure Internet-based system with built-in software checks and user in for-mat ion prompts to ensure completeness, uniformity, and validity of the data. Data automation tools are also available to lower the data entry burden on the SCNRs and to improve the quality of the data being captured. The output of the collected data are semiannual reports which include the hospital’s risk adjusted outcomes expressed as observed versus expected (O/E) ratios for 30-day morbidity and morality. These reports allow each facility to compare its outcomes with the national average and the averages in its peer group of hospitals. In addition, the Web site offers 24/7 access to user-friendly, real-time reports that allow hospitals to view their non-risk-adjusted data, as well as compare their data to national averages. Another strength of the ACS NSQIP data collection system is its flexibility to add new data collection modules. The initial 133 data points focus on general and vascular surgeries but data points for bariatric surgery are in the final stages of development. Additionally, the ACS NSQIP has developed a data collection tool to capture the Centers for Medicare and Medicaid (CMS) Surgical Care Improvement Project (SCIP) process measures. Both the ACS NSQIP and SCIP have as their core mission the improvement of care for surgical patients. By participating in the ACS NSQIP with the inclusion of the SCIP process measures a hospital will fully meet the reporting requirement for the CMS SCIP project. You can learn more about the ACS NSQIP and SCIP connection at the Surgical Care Improvement Project Link under the Resources heading. To learn more about the ACS NSQIP participation requirements, nurse training, application process, or other general information you can visit http://www.acsnsqip.org/. An online form is also available for hospitals interested in applying to the program.
American College of Surgeons – National Trauma DataBank (NTDB)The NTDB represents the largest compilation of traumatic injury data in the United States and contains detailed clinical indicators and other trauma care information on patients admitted into hospitals. This page contains background information about the data points, how to submit data to the NTDB, and how to request use of the database for research initiatives. Additionally, online users are able to access the most current version of the database and perform online analytical processing to analyze NTDB aggregate data. The National Trauma Data Bank Pediatric Report is provided in pdf format as well. American College of Surgeons – National Cancer Data Base (NCDB)The NCDB was established in 1989 with support from both the American Cancer Society and the ACS to serve as a comprehensive clinical surveillance resource for cancer care in the United States. The NCDB is a nationwide, facility-based, oncology data set that currently captures 75 percent of all newly diagnosed cancer cases in the United States annually. The National Cancer Data Base link sends users to a page that contains the following information about the NCDB: general information, statistics, data submission information, Commission on Cancer (COC) surveillance and special studies, data standards, third party researchers, and data confidentiality. The Cancer Programs Databases link sends users to a page that allows users to search for Approved Cancer Programs, Frequently Asked Questions, National Cancer Database Benchmark Reports, and National Cancer Database Survival Reports. There is also a variety of background information about the NCDB and information pertaining to data standards. Data collected through the NCDB are provided by the 1,400 COC approved hospitals. Revised January 18, 2006
by the American College of Surgeons, Chicago, IL 60611-3211 |
