American College of Surgeons Goal: Enlist 1,000 Hospitals in Quality Improvement Program

The American College of Surgeons (ACS) has set a goal to enlist at least 1,000 hospitals into its respected National Surgical Quality Improvement Program (ACS NSQIP). The commitment is part of the ACS Inspiring Quality initiative, an effort to raise awareness of proven models of quality improvement, coordinated care, and disease management that can help improve the quality and value of health care.

The announcement was made in conjunction with the Chicago Surgical Health Care Quality Forum, an event aimed at raising awareness of quality issues and discussing quality improvement programs needed in U.S. hospitals to reduce preventable hospital readmissions, prevent medical errors, improve patient outcomes, and reduce costs. Nearly 50 Chicago health care leaders attended the event, which was held at ACS's downtown headquarters.

U.S. Senator Mark Kirk (R-Ill.) served as keynote speaker at the event, and panelists included leaders from Chicago academic medical centers, medical schools, hospitals and nonprofit health care organizations. Dr. L. D. Britt, ACS president, kicked-off the panel discussion by asking Sen. Kirk if his colleagues in Washington understood that quality improvement programs save money as well as lives.

“The college’s programs prove that quality can equal cost effectiveness,” says Britt. “We’re here talking about saving lives and reducing costs.”

“The American College of Surgeons has a century-long history of setting standards, measuring outcomes, and using outside verification to improve the quality of care,” says Dr. David B. Hoyt, executive director of ACS. “Our quality programs are proven to prevent complications, save lives, and lower costs. If we could get ACS NSQIP into more hospitals around the country, we could prevent millions of complications, save thousands of lives, and reduce costs by billions of dollars—every year.”

To encourage hospitals to collaborate and share best practices in quality improvement, ACS will host a series of community forums across the nation with health care leaders representing academic medical centers and medical schools, hospitals, and nonprofit health care associations. Following the recent forum, other locations will include California, Maryland, Massachusetts, Pennsylvania, Texas, Virginia, and Washington.

As part of the initiative, ACS has also released a series of videos that capture what “inspiring quality” means from the perspective of patients, surgeons, and the overall industry. These videos can be found on the ACS website. Additional videos will be added to the site as meetings are held across the country.

“To improve quality, hospitals and surgeons need to set and accurately measure themselves against relevant and significant standards and have the right resource infrastructure in place to treat their patients,” says Dr. Carlos Pellegrini, chair of the ACS board of regents. “But saying we want to improve quality isn’t enough. We all must be willing to work together and hold ourselves accountable for doing it. Coming together peer to peer and discussing best practices for quality improvement is not only beneficial from a hospital’s perspective, it’s also the right thing to do for our patients.”

Supporting the National Quality Strategy

Coordinated quality and patient safety efforts are an important national focus with the release this year of the National Quality Strategy, led by the U.S. Department of Health and Human Services. Getting at least 1,000 hospitals into ACS NSQIP can dramatically accelerate movement toward meeting National Quality Strategy goals. Currently about 400 hospitals participate in ACS NSQIP, which is based on collecting clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database.

Called “Best in the Nation” by the Institute of Medicine, ACS NSQIP is serving as a national model for outcomes-based quality improvement. The Centers for Medicare and Medicaid Services (CMS) is currently considering five measures based on ACS NSQIP’s more than 40 measures, for potential national implementation as early as 2012.

“Over the past decade, we’ve learned a lot about what works and what doesn’t to improve health care quality,” says Dr. Clifford Ko, one of the quality improvement panelists. “We are now on the verge of significant changes in our health system. We know the ACS NSQIP methodology that has been developed and refined over the past decade is effective in improving care, and we now hope to spread these learnings and successes to more hospitals across the country.”

Reducing costs and complications

ACS NSQIP has been shown to help hospitals significantly reduce complications and save lives. A 2009 study in the Annals of Surgery found participating hospitals prevented 250–500 complications and save 13–26 lives per hospital per year. At an average cost of $11,000 per complication, hospitals can save millions of dollars a year.

“ACS has been a national force for quality since its founding in 1913. In the current era, safe care with excellent outcomes is a major focus, building on proven quality improvement programs of the college,” says Dr. J. Michael Henderson, chief quality officer at the Cleveland Clinic and chair of the ACS NSQIP advisory board. “ACS NSQIP is a program that leads to better patient outcomes and lower costs by reducing preventable complications. This is a program that is implemented by the clinical caregiver, uses basic best practices, and has been proven to work for our patients.”

“Mercy is a not-for-profit Catholic Hospital owned by the Sisters of Mercy, with a mission to take care of everyone irrespective of their race or economic status,” says Dr. Alejandra Perez-Tamayo, chief of surgery at Mercy Hospital and Medical Center. “Because of this, we count our pennies very closely. Through the close and productive relationship between the administration of the hospital and its physician leaders, ACS NSQIP was identified as a surgical quality program worth investing in. Using ACS NSQIP, Mercy has been able to identify opportunities for improvement, reduce infection rates, deep vein thrombosis, pulmonary embolism, and develop multidisciplinary teams and programs that develop processes for better care.”

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