A. N. Kulaylat1, Z. A. Gregg1, W. Sangster1, G. Ortenzi1, E. Messaris1 1Penn State Hershey Medical Center,Division Of Colon And Rectal Surgery, Department Of Surgery,Hershey, PA, USA
Introduction: Clinical outcomes data are playing an increasingly important role in reimbursement, provider evaluation and everyday clinical practice. Furthermore, physicians can use the data to improve the quality of the provided care. The objective of this study is to report a single hospital's experience using the National Surgical Quality Improvement Program (NSQIP) as an instrument to improve outcomes after colorectal surgery resections.
Methods: Raw institutional and national risk adjusted NSQIP data in a tertiary facility were annually reviewed and changes were implemented to improve outcomes. Special bundles were implemented for prevention of urinary tract infections (UTI) and venous thromboembolic events (VTE). All targeted colectomies and proctectomies from 2011 to 2013 were reviewed and the following outcome measures were recorded: mortality, overall morbidity, urinary tract infections, venous thromboembolic events and surgical site infections (SSI).
Results: A total of 803 cases met our criteria. Our ACS NSQIP overall colorectal UTI and VTE rates for 2011 were 3.6% and 2.8% respectively. After implementation of the new practice parameters both UTI and VTE rates decreased in 2013 to 1.4% and 1.75%, respectively (Figure 1). Furthermore, mortality and overall morbidity improved from 4.68% and 20.8% in 2011 to 1% and 15.4%, respectively. On the contrary, outcomes for which we did not implement practice parameters, such as SSI’s, did not demonstrate any improvement from 2011 (7.4%) to 2013 (9.1%).
Conclusion: 1) NSQIP enabled our institution to identify sources of preventable morbidity. 2) By implementing changes in our clinical practice, we were able to lower our rate of UTI’s and VTE’s. 3) NSQIP should be used as a tool that drives quality improvement and not just quality reporting.
