CHICAGO: In collaboration with the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, the American College of Surgeons today issued a national call for interested hospitals to join the third cohort of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR).
Funding and guidance from AHRQ allows hospitals across the U.S. to implement enhanced recovery pathways, which have been shown to to improve safety, shorten recovery times, and reduce length of stay for surgical patients. The AHRQ ISCR program, launched in the fall of 2016, seeks to improve surgical patient outcomes by increasing the implementation of enhanced recovery practices in participating hospitals through the use of an adaption of AHRQ’s Comprehensive Unit-based Safety Program (CUSP), a well-known model for sustainable safety improvement that has been associated with preventing harm in multiple areas.
The AHRQ ISCR program will be implemented as an integrated combination of clinical and hospital team cultural interventions in all participating hospitals. Originally introduced and successfully used in European hospitals, enhanced recovery programs are a compilation of preoperative, intraoperative, and postoperative practices that have been shown to decrease surgical patients’ complications and speed their recovery, as shown through numerous published reports in the medical literature. “This is a tremendous opportunity to pull all of our learnings in surgical improvement together to accelerate improvement across the country,” said Elizabeth C. Wick, MD, associate professor of surgery, University of California, San Francisco, and Co-Principal Investigator of the AHRQ ISCR Program.
Since the start of the first cohort in July 2017, the AHRQ ISCR program has actively supported participants in implementing evidence-based surgical care. The initial cohort focused on colorectal surgery. The second cohort launched in March 2018, expanding the work to include total joint replacement and hip fracture surgery. A third cohort is set to start March 1, 2019, with a focus on gynecologic surgery, but hospitals can still join and work on colorectal, total joint replacement, and hip fracture pathways as well.
This comprehensive program allows participating hospitals to work to improve surgical patient outcomes, reduce length of stay, prevent complications, increase reliability and standardization of care, improve efficiency, and improve surgical teamwork and the hospital’s surgical care culture. “Through this program, hospitals can improve their outcomes and build their teams and the culture they’ll need to propel them even further,” said Co-Principal Investigator of the AHRQ ISCR Program, Michael A. Rosen, PhD, who is also an associate professor of anesthesiology and critical care medicine and a faculty member with the Johns Hopkins Armstrong Institute for Patient Safety and Quality.
Participating hospitals receive a ready-to-use pathway, access to education materials on how to implement the pathway, access to experts in performance improvement and education who will help them troubleshoot as they implement, and inclusion in a community of surgeons and clinicians rolling out the same pathway.
“We’re very excited about the expansion of the AHRQ Safety Program for Improving Surgical Care and Recovery to include additional cohorts and involve more surgical specialties,” said Clifford Y. Ko, MD, FACS, Director of the ACS Division of Research and Optimal Patient Care, and Co-Principal Investigator of the AHRQ ISCR program. “The program enables us to provide a high-quality framework for hospitals across the nation to use in successfully delivering better outcomes for their surgical patients.”
Enrolled hospitals also have the opportunity to join monthly coaching calls and national leader webinars to learn from their colleagues and other experts in the field. Coaching calls are discussion driven on topics such as patient and staff education, specific clinical practice area changes such as bowel preparation or multimodal analgesia, and barriers to and facilitators of implementation, including such issues as coordinating multidisciplinary teams, communicating and working across units, surgeon engagement, or the electronic health record. National leader webinars take on a clinical focus with topics like bowel prep versus oral antibiotics, preoperative lab testing, venous thromboembolism prophylaxis, building a culture of mobility, and delirium screening.
In addition to faster recovery times, surgical patients can benefit from safer surgery practices and an overall better patient experience when they undergo operations in participating hospitals.
“Providing surgeons and their institutions with the knowledge and resources to improve the quality and safety of surgical care is directly aligned with our ACS mission. We think that surgical patients will gain tremendous benefits through this initiative and that it will ultimately transform American surgery,” said ACS Executive Director David B. Hoyt, MD, FACS.
“FACS” designates that a surgeon is a Fellow of the American College of Surgeons.
AHRQ Safety Program for Improving Surgical Care and Recovery is funded by the Agency for Healthcare Research and Quality, Contract # HHSP233201500020I
