Preliminary NSQIP results: a tool for quality improvement.
OBJECTIVE
To utilize National Surgical Quality Improvement Program (NSQIP) data to evaluate patient outcomes in otolaryngology-head and neck surgery.


METHODS
Retrospective medical chart abstraction of patients undergoing major surgical procedures in the inpatient and outpatient setting.


METHODS
Academic/teaching hospitals with more than 500 beds.


METHODS
The American College of Surgeons NSQIP collects data on 135 variables including preoperative risk factors, intraoperative variables, and 30-day-postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures in the inpatient and outpatient setting. As of August 2008, there are currently 47 hospitals submitting data for otolaryngology-head and neck surgery.


RESULTS
Opportunities for improvement were identified in respiratory, wound, and venothromboembolic (VTE) occurrences. Implementation of a standardized VTE and perioperative protocol resulted in a decreased length of stay and observed-to-expected (O/E) morbidity and mortality for all surgical services.


CONCLUSIONS
NSQIP reports form the basis for quality improvement with targeted interventions in areas of concern that result in changes in patient care processes. The reports are composed of outcomes-based, risk-adjusted data that are submitted by participating hospitals and have recently included data for otolaryngology-head and neck surgery. Actions taken based on NSQIP data demonstrate improvements in patient morbidity and mortality, decreased length of stay, and decreased hospital costs. In a time of increased scrutiny of health care costs and outcomes, NSQIP is an important tool for surgeons to improve quality and decrease costs.
Stachler
Robert J
RJ
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, MI, USA.
Yaremchuk
Kathleen
K
Ritz
Jennifer
J
D015331:Cohort Studies; D016208:Databases, Factual; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States