American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

New Study Shows Florida’s Participation in Innovative ACS NSQIP Surgical Collaborative Resulted in Statewide Improvement

Authors of the Journal of the American College of Surgeons study say the results support the case for a national ACS NSQIP initiative to improve quality and reduce costs of surgical care


CHICAGO (April 2, 2014): A surgical collaborative of hospitals across Florida resulted in broad improvement in the state, helping most hospitals significantly improve, according to a new study published in the April issue of the Journal of the American College of Surgeons.

Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®), the Florida Surgical Care Initiative (FSCI) was able to reduce complications by 14.5 percent. The study looks at a 15-month period from March 2011 to July 2012 in which it estimates that the program averted 165 complications, saved an estimated 89 lives, and avoided more than $6.6 million in health care expenses.

“The results of the Florida initiative show that the ACS NSQIP process, applied across a population by committed institutions, can produce dramatic results,” said Joseph J. Tepas III, MD, FACS, the lead author of the study: “Macro vs Micro Level Surgical Quality Improvement: A Regional Collaborative Demonstrates the Case for a National NSQIP Initiative.”

The research team set out to assess whether FSCI’s significantly improved overall results were due to a few outperformers or due to broad-based improvement. The researchers found that most of the 54 participating Florida hospitals improved, and some significantly improved. They also found that the level of improvement for each measure differed from hospital to hospital.

“Almost all hospitals improved, but some improved more than others, and that improvement varied across measures,” Dr. Tepas said. “This shows that the global improvement was not the result of a few high performers and that the NSQIP process created a commitment to performance improvement among all of the participants, although with varying degrees of success.”

The researchers also argue that the results support the case for the ACS NSQIP collaborative as a systems approach to population-based improvement in surgical care.

FSCI is a joint project between the Florida Hospital Association and ACS that focuses on four ACS NSQIP measures: Surgical site infections, catheter-associated urinary tract infections, colorectal infections and surgery in elderly patients (65 years or older). ACS NSQIP provides risk-adjusted data gathered from medical charts and patient outcomes 30 days after the operation (more than half of all complications happen after discharge).

Contributors to this study of an ACS NSQIP collaborative include Joseph J. Tepas III, MD, FACS; Andrew J. Kerwin, MD, FACS; Jhun deVilla, MD; and Michael S. Nussbaum, MD, FACS.

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 79,000 members and is the largest organization of surgeons in the world. For more information, visit


Dan Hamilton
Sally Garneski