Process improvement in surgery

Christina A. Minami, Catherine R. Sheils, Karl Y. Bilimoria, Julie K. Johnson, Elizabeth R. Berger, Julia R. Berian, Michael J. Englesbe, Oscar D. Guillamondegui, Leonard H. Hines, Joseph B. Cofer, David R. Flum, Richard C. Thirlby, Hadiza S. Kazaure, Sherry M. Wren, Kevin J. O'Leary, Jessica L. Thurk, Gregory D. Kennedy, Sarah E. Tevis, Anthony D. Yang

Research output: Contribution to journalArticlepeer-review

17 Scopus citations
Original languageEnglish (US)
Article number508
Pages (from-to)62-96
Number of pages35
JournalCurrent Problems in Surgery
Issue number2
StatePublished - Feb 1 2016

Bibliographical note

Funding Information:
ACS-NSQIP emerged from the National Veterans Administration Surgical Risk Study, founded in 1991, which revealed significant improvements in surgical outcomes. 18 The concept was expanded to hospitals in the private sector in 1999 as ACS-NSQIP, supported by a patient safety grant from the Agency for Healthcare Research and Quality (AHRQ). ACS-NSQIP has grown steadily over the years, now counting more than 600 participating hospitals both in the United States and internationally. In 2002, the IOM named ACS-NSQIP “the best in the nation” for measuring and reporting surgical quality and outcomes. More recently, the ACS-NSQIP has been awarded the 2014 John M. Eisenberg Patient Safety and Quality Award in the category of Innovation in Patient Safety and Quality at the National Level.

Funding Information:
Dr Minami is funded under an institutional award from the Agency for Healthcare Research and Quality, United States , T-32 HS 000078 (P.I.: Jane L. Holl, MD MPH). Dr Englesby is an equity stakeholder in Prenovo.

Funding Information:
A formal DMAIC project was initiated to boost compliance with the VTE measures. Team members included an internist with QI expertise, a surgeon with QI expertise, a process improvement leader, a quality measures specialist, a data analyst, a surgical resident, a nurse education coordinator, a clinical pharmacist, and a hospital medicine team leader. The project was sponsored by the hospital’s Chief of Staff and an anesthesiologist.

Funding Information:
The Tennessee founders emphasized that the collaborative would be an effort controlled by surgeons and would be built on 3 factors: funding, data management across multiple institutions, and data sharing. Funding came from the Blue Cross Blue Shield Foundation of Tennessee, and this financial support went toward salaries for nurse reviewers, a stipend for the surgeon champions, and for administrative support through the Tennessee Center for Patient Safety. Data used for the collaborative was managed by the Tennessee Center for Patient Safety program. Although sharing of the data throughout the collaborative was facilitated by the development of a website, the Tennessee collaborative emphasizes that human collaboration underlies their success. The initiation of a successful collaborative rests on the knowledge that effective use of data can improve patient care and is a high priority for individual surgeons as well as institutions. How these data are then used rests on a shared vision of improvement. The concept of data sharing among the hospitals without fear of retribution was shared with the Michigan consortium. No data would be used for marketing or advertising and the good of the collaborative is recognized to come before the individual institution.

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