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

Quality Support Tools

Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) have access to a wide range of evidence-based support tools.

Best Practices Guidelines 

The ACS NSQIP Best Practices Guidelines were designed to serve as complete, yet concise resources for healthcare providers and quality improvement professionals. They provide a framework that can be used to prioritize and direct efforts to address postsurgical complications. The Guidelines are evidence-based, and have been assembled through reviews of the current literature and consultation with expert panels.

Best Practices Case Studies

The ACS NSQIP Best Practices Case Studies booklet, issued yearly, showcases success stories of how participating hospitals have analyzed ACS NSQIP data and implemented quality improvement initiatives to better their performance and outcomes. Through the Case Studies, ACS NSQIP participants can learn from the experiences of other hospitals and develop similar initiatives within their own facilities.

Risk Calculator

Surgical consultations can require patients to deal with difficult and complex information, provoking anxiety that diminishes their ability to process information or recall vital details. In the past, surgeons have assessed the risks of surgery through the lens of their own experience. Today, ACS NSQIP data powers a preoperative risk calculator tool that allows clinicians to input an individual patient’s risk factors, such as age, sex and BMI, into a statistical model that calculates the likelihood of various outcomes. Physicians receive charts indicating the patient’s specific risk, based on their own risk factors. The tool aids physicians in speaking with their patients about risks and benefits of procedures and helps in the informed consent process.

Risk calculators have been developed for common procedures, such as pancreatectomy, colorectal and bariatric surgeries, with calculators for additional procedures in development. They provide better predictive ability than most other models across a range of outcomes, including morbidity, serious morbidity and mortality.


Collaboratives are groups of ACS NSQIP participating hospitals that come together to discuss best practices, quality improvement initiatives and/or to compare their surgical outcomes in a positive learning environment. There are currently more than 20 ACS NSQIP collaborative groups in existence or in development. Each collaborative group receives technical support and guidance from ACS NSQIP in developing data-sharing strategies, designing specialized reports and publicizing the group’s efforts. Some collaboratives have partnered with payors. Payor involvement can reduce costs for hospitals and increase the number of participants in a collaborative.

Collaboratives may be:

  • Regional (e.g., Tennessee Surgical Quality Collaborative, comprising 10 hospitals)
  • System-wide (e.g., Kaiser Permanente Northern California, with six hospitals)
  • Virtual (e.g., uniting around a specific outcome or procedure, like colectomy or glucose control)
  • Additionally, a rural pilot is being developed, tailored to the needs of small hospitals.

National Conference

Each year, the ACS NSQIP national conference provides a professional forum for Surgeon Champions, SCRs and other hospital employees involved in ACS NSQIP quality efforts to discuss and apply the most recent knowledge pertaining to national and local surgical quality initiatives. There are practical sessions on analysis and use of ACS NSQIP data as well as break out sessions on surgical topics and by level of ACS NSQIP experience. ACS subsidizes the session fees for two attendees from each site. (Attendees are required to pay a nominal administrative fee and travel expenses.)

Monthly Surgeon Champion and SCR Calls

Surgeon Champions and SCRs further their networking and learning opportunities by participating in monthly calls hosted by ACS NSQIP program staff. Each interactive monthly call focuses on a specific quality improvement or program topic, and participating sites often share their case studies and learnings with each other.

Quality Improvement Primers

ACS NSQIP primers are designed as concise resources for healthcare providers and quality improvement professionals. They contain information assembled through reviews of current literature and consultation with experts in the field. There are currently primers on two topics in this series:

  • Statistical Process Control Charts
  • Leading and Managing Organizational Change