Designing a Surgical Quality Improvement Project at Eastern State Medical Center

Case Solution

Amy P. Cohen, Nancy M. Kane
Harvard T. H. Chan School of Public Health ()

In this case, the challenges, benefits, and costs of hospital participation in a widely recognized benchmarking program aimed at improving surgical quality are examined. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) reports twice a year to participating hospitals and benchmarks based on data submitted by more than 500 hospitals. Participation in NSQIP claims reduces surgical complications. The protagonist, chief surgeon general of a major academic medical center, is skeptical about the value of the report on two fronts: by some of his staff surgeons and by a statistician whom he consults. Some of the surgeons at the hospital find the data difficult to interpret and question its usefulness when focusing on quality improvement measures. The statistician has reservations about the informative value of the statistical results as a basis for action. The manager has to decide whether and in what way the NSQIP report can be used to improve quality. In the coming era of value-based hospital purchasing initiatives, the boss must also be concerned with how payers might interpret this data as they develop payment systems that reflect available surgical quality metrics.

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