title: Developing a NSQIP module to measure outcomes in children's surgical care: opportunity and challenge.
abstract: Under the guidance of the American College of Surgeons (ACS) and in partnership with the US Department of Veterans Affairs (VA), the National Surgical Quality Improvement Program (NSQIP) has been developed to improve the quality of surgical care in adults on a national level. Its purpose is to provide reliable, risk-adjusted outcomes data so that surgical quality can be assessed and compared between institutions. Data analysis consists of reporting observed to expected ratios (O/E) for 30-day postoperative mortality and morbidity measurements. A surgical clinical nurse reviewer is assigned at each medical center to collect information on 97 variables, including preoperative, operative, and postoperative factors for patients undergoing major operations in the specialties of general and vascular surgery. Eligible operations are entered into the database on a structured 8-day cycle to ensure representative sampling of cases. Since the introduction of the program into the VA system, there has been a 47% reduction in 30-day postoperative mortality and a 42% reduction in 30-day postoperative morbidity. Over 160 institutions have enrolled with the ACS in its adult NSQIP. In 2005, a planning committee was formed by the ACS and the American Pediatric Surgical Association to explore the development of a children's surgery NSQIP module. In conjunction with the Colorado Health Outcomes Program at the University of Colorado, a program potentially applicable to all children's surgical specialties has been designed. This manuscript describes the development of that Children's ACS-NSQIP module.
authors.affiliation: Penn State Children's Hospital, Hershey, Pennsylvania 17033, USA. pdillon1@psu.edu
authors.forename: Peter
authors.initials: P
authors.lastname: Dillon
authors.forename: Karl
authors.initials: K
authors.lastname: Hammermeister
authors.forename: Elaine
authors.initials: E
authors.lastname: Morrato
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
authors.forename: Keith
authors.initials: K
authors.lastname: Oldham
authors.forename: Lawrence
authors.initials: L
authors.lastname: Moss
authors.forename: Michael
authors.initials: M
authors.lastname: Marchildon
authors.forename: Moritz
authors.initials: M
authors.lastname: Ziegler
authors.forename: Janet
authors.initials: J
authors.lastname: Steeger
authors.forename: Kathy
authors.initials: K
authors.lastname: Rowell
authors.forename: Mira
authors.initials: M
authors.lastname: Shiloach
authors.forename: William
authors.initials: W
authors.lastname: Henderson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D016208:Databases, Factual; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000401:mortality*; D011785:Quality Assurance, Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards; D013043:Specialties, Surgical / Q000592:standards; D013514:Surgical Procedures, Operative / Q000592:standards*; D016019:Survival Analysis; D015996:Survival Rate; D014481:United States