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Surgical quality program cuts complications, patient deaths

Giving surgeons reliable clinical data is key to helping them pinpoint safety problems, researchers say.

By Kevin B. O’Reilly — Posted Sept. 21, 2009

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Nearly 120 hospitals participating in a surgical quality program cut their complication rates by an average of 11% and slashed mortality rates by 18%, according to a study in the September Annals of Surgery.

Two-thirds of the hospitals that took part in the American College of Surgeons' National Surgical Quality Improvement Program from 2006 to 2007 saw reductions in their mortality rates, and 82% lowered their number of surgical complications, the study found.

If each hospital in the U.S. could achieve similar results, millions of complications could be avoided each year, researchers estimated. Postoperative complications are not only deadly, accounting for one in five preventable deaths according to previous research, but also very costly. Caring for one surgical site infection can cost nearly $30,000, for example.

The college's initiative is modeled after a successful program developed in the 1990s in the Veterans Health Administration that cut surgical mortality and morbidity and hospital stays, and improved patient satisfaction. The program helps hospitals collect and analyze clinical, risk-adjusted outcomes data so surgeons can spot potential problems. It is the quality of the clinical data that helps bring surgeons on board, said study co-author Clifford Y. Ko, MD.

"The fact that it's clinical data and that it's risk-adjusted means that it's the best data to get the buy-in of the surgeons to participate in the quality improvement," said Dr. Ko, director of the division of research and optimal patient care at the American College of Surgeons. "Otherwise, the initiatives just don't get off the ground."

Detailed data by surgeon, type of surgery, patient condition and more give doctors the ability to fine-tune protocols and procedures that could yield improvements, said Dr. Ko, a colon and rectal surgeon who is professor of surgery at the University of California, Los Angeles, David Geffen School of Medicine.

The program costs $35,000 annually and requires the hospital to train someone to review and properly code all surgical clinical data. More than 250 hospitals have signed up for the college's surgical quality project.

But that's just the beginning, Dr. Ko said.

"Just paying your money to join the program will not be as good as joining the program and actively participating in doing quality improvement," he said.

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External links

"Does Surgical Quality Improve in the American College of Surgeons National Surgical Quality Improvement Program: An Evaluation of All Participating Hospitals," abstract, Annals of Surgery, September (link)

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