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Risk-Adjusted Surgical Data to Improve Surgical Quality

July 1, 2009

Bozeman Deaconess Hospital is participating in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). Director of Surgical Quality Charles F. Rinker II, MD, oversees the NSQIP program and Rene Fredette, RN, BSN, CPAN, is surgical quality coordinator and nurse reviewer.

According to Rinker NSQIP is going to improve quality of care in the OR. He says the risk-adjusted database will allow Bozeman Deaconess to compare against national norms that take into consideration that some hospitals see more very sick and complicated patients than others. "It levels the playing field," he says. "Risk-adjusted data will help us see areas where we should improve surgical practices."

"We're going to be able to compare our expected outcomes to actual observed outcomes," says Fredette. She'll query patients and surgeons and post abstracted data into a database that adjusts raw data to account for patients' risk factors.

"NSQIP is a mechanism for data collection and analysis that is just one component of our overall surgical quality improvement program," notes Darci Bentson, quality management director and the hospital's risk manager. Participating in NSQIP, she says, will quantify risk-adjusted surgical outcomes and allow valid comparison of outcomes among the 230 plus hospitals in the program. Participating hospitals and their surgical staff are provided with the tools, reports, analysis and support necessary to make informed decisions about improving quality of care.

How will the program work? After selecting surgical cases that meet NSQIP criteria, Fredette will make 30-day post op callbacks to general surgery, orthopedics, gynecology, urology and ear nose and throat patients to attain necessary outcome data. In addition to gathering the necessary data for the outcome study, her calls will provide continuation of care.

"The goal of our surgical quality program is to improve our care and to improve our outcomes," says Fredette. Shelly Satterthwait, director, Surgical Services, agrees. "Post-op surveillance that generates accurate data analysis of our patient outcomes is a positive thing," she said.

Data will be submitted to the American College of Surgeons for review and NSQIP will produce risk-adjusted reports that Bozeman Deaconess can benchmark with other hospitals.

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