title: The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
abstract: Postoperative adverse events occur all too commonly and contribute greatly to our large and increasing healthcare costs. Surgeons, as well as hospitals, need to know their own outcomes in order to recognise areas that need improvement before they can work towards reducing complications. In the USA, the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) collects clinical data that provide benchmarks for providers and hospitals. This review summarises the history of ACS NSQIP and its components, and describes the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety. The potential harms and limitations of the program are discussed.
authors.affiliation: VA Greater Los Angeles Healthcare System, Los Angeles, California, USA Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA Department of Surgery, Olive View-UCLA Medical Center, Sylmar, California, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Maggard-Gibbons
mesh_terms: D019985:Benchmarking / Q000379:methods*; D013502:General Surgery / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012955:Societies, Medical; D014481:United States / Q000453:epidemiology
keywords: Health Services Research; Quality Improvement; Quality Measurement; Report Cards; Surgery
references.citation: J Am Coll Surg. 1995 May;180(5):519-31
references.pmid: 7749526
references.citation: Natl Health Stat Report. 2010 Oct 26;(29):1-20, 24
references.pmid: 21086860
references.citation: Perm J. 2012 Winter;16(1):39-45
references.pmid: 22529758
references.citation: BMJ. 2007 Oct 13;335(7623):759
references.pmid: 17884862
references.citation: J Am Coll Surg. 2011 Jan;212(1):1-11
references.pmid: 21036076
references.citation: N Engl J Med. 2001 Aug 30;345(9):692-4
references.pmid: 11547726
references.citation: Circulation. 1996 Jan 1;93(1):27-33
references.pmid: 8616936
references.citation: J Am Coll Surg. 2006 Jun;202(6):933-7
references.pmid: 16735208
references.citation: J Am Coll Surg. 2013 Aug;217(2):336-46.e1
references.pmid: 23628227
references.citation: Am J Surg. 2009 Nov;198(5 Suppl):S69-73
references.pmid: 19874938
references.citation: Ann Surg. 2011 Oct;254(4):619-24
references.pmid: 22039608
references.citation: JAMA. 1994 Mar 9;271(10):761-6
references.pmid: 8114213
references.citation: N Engl J Med. 2006 Dec 28;355(26):2725-32
references.pmid: 17192537
references.citation: Ann Surg. 1998 Oct;228(4):491-507
references.pmid: 9790339
references.citation: Arch Surg. 2010 Oct;145(10):985-91
references.pmid: 20956768
references.citation: JAMA. 2005 Jun 22;293(24):2999-3000; author reply 3000-1
references.pmid: 15972560
references.citation: Am J Med. 1998 Sep;105(3):236-41
references.pmid: 9753027
references.citation: Med Care. 2003 Aug;41(8):979-91
references.pmid: 12886177
references.citation: Ann Surg. 2011 Mar;253(3):611-8
references.pmid: 21183845
references.citation: Ann Surg. 2009 Sep;250(3):363-76
references.pmid: 19644350
references.citation: J Am Coll Surg. 1997 Oct;185(4):315-27
references.pmid: 9328380
references.citation: Adv Surg. 2010;44:251-67
references.pmid: 20919525
references.citation: Med Care. 2005 Feb;43(2):122-31
references.pmid: 15655425
references.citation: J Pediatr Surg. 2011 Jan;46(1):115-21
references.pmid: 21238651
references.citation: Ann Surg. 2008 Aug;248(2):329-36
references.pmid: 18650645
references.citation: Surgery. 2008 Oct;144(4):662-7; discussion 662-7
references.pmid: 18847652
references.citation: Ann Intern Med. 2001 Nov 20;135(10):847-57
references.pmid: 11712875
references.citation: J Am Coll Surg. 2012 Apr;214(4):709-14; discussion 714-6
references.pmid: 22265639
references.citation: J Am Coll Surg. 2004 Oct;199(4):531-7
references.pmid: 15454134
references.citation: Ann Surg. 2010 Sep;252(3):514-9; discussion 519-20
references.pmid: 20739852
references.citation: Cardiovasc Surg. 2000 Oct;8(6):409-10
references.pmid: 11184739
references.citation: J Am Coll Surg. 2010 Jan;210(1):6-16
references.pmid: 20123325
references.citation: J Surg Res. 2011 Mar;166(1):e15-25
references.pmid: 21176914
references.citation: Ann Surg. 2002 Sep;236(3):344-53; discussion 353-4
references.pmid: 12192321