A focus on quality has captured the nation’s attention, as government-driven reform, demographics and economic trends create permanent changes in the delivery of healthcare. Payers want to review the quality of care they reimburse. Empowered patients demand information to assess the quality of their hospitals and surgeons. At the same time, an aging population and the ever more expensive cost of care increasingly stress existing payment structures. The American College of Surgeons National Surgical Quality Improvement Program® (ACS NSQIP®) can help your hospital stay ahead of the curve. Below are a few important developments.
Quality Leadership on Display: Voluntary Participation in Hospital Compare
The American College of Surgeons (ACS) and CMS have partnered to allow ACS NSQIP hospitals to voluntarily report their outcomes on the publicly accessible Hospital Compare website. Because ACS NSQIP is based on the best available data—clinical, risk- and case-mix-adjusted, nationally benchmarked and audited 30-day patient outcomes—it provides a more accurate look at surgical quality than many other public measures, which are based on administrative data or compliance with process measures.
Participating hospitals are able to voluntarily report on three measures endorsed by the National Quality Forum: elderly surgery outcomes, colectomy outcomes and lower-extremity bypass. Hospitals can choose to report just one measure or any combination of the three. The Hospital Compare website explains the rigor of ACS NSQIP data so that patients better understand what the measures mean, the importance of accurate, risk-adjusted data, and how to use the information in making their care decisions.
Quality Does Improve
Over the past several years, many studies have reported demonstrable improvements being achieved in ACS NSQIP hospitals.
- A 2009 study by Hall showed that more than 80% of the hospitals improved their complication rates and about two-thirds of hospitals improved their mortality rates.1
- A 2012 study from the Tennessee Collaborative demonstrated improvements in several clinical areas as well as cost savings in the millions of dollars.2
- A 2015 study with a follow-up period of eight years similarly showed that approximately 70% of hospitals achieved statistically significant decreases in surgical complications and two-thirds achieved statistical decreases in mortality. It is one of the longest longitudinal studies demonstrating surgical quality improvement.3
- Finally, there have been literally hundreds of presentations at the annual ACS NSQIP conferences that have shared how individual hospitals have accomplished demonstrable local improvement.
- Hall BL HB, Richards K, Bilimoria KY, Cohen ME, Ko CY. Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals. Annals of Surgery. 2009;250(3):363-376.
- Guillamondegui OD GO, Hines L, Martin BJ, Gibson W, Clarke PC, Cecil WT, Cofer JB. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to improve surgical outcomes. Journal of American College of Surgeons. 2012;214(4):709-714.
- Cohen ME, Liu Y, Ko CY, Hall BL. Improved Surgical Outcomes for ACS NSQIP Hospitals Over Time: Evaluation of Hospital Cohorts With up to 8 Years of Participation. Annals of Surgery, 2015 Feb 26.