National Surgical Quality Improvement Program integration with Morbidity and Mortality conference is essential to success in the march to zero.
BACKGROUND
Morbidity and Mortality conference (M&M) and the National Surgical Quality Improvement Program (NSQIP) are systems to improve surgical care. We evaluated the commonality of adverse events (AEs) and the change in AE rates after integration.


METHODS
A single institution's NSQIP and M&M registries were analyzed to determine commonality of AE reported. Causal determinant groups were then created to categorize and standardize AE. Incidence of AE and patient commonality identified by these systems was evaluated over 2 years.


RESULTS
The 68 common patients identified in 2012 represented 27% of NSQIP and 43% of M&M patients. Common AE reported by M&M and NSQIP decreased from 16.9% (2013) to 9.6% (2014). Causality code analysis demonstrated significant differences in proportion of issues addressed within each (P < .0001).


CONCLUSIONS
Despite standardized coding, M&M focus differed from NSQIP. Low commonality affirms NSQIP as a critical adjunct to voluntary reporting. Combining both may help eliminate preventable AEs.
Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA. Electronic address: lgurien@gmail.com.
Lori A
LA
Gurien
Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA.
Jin H
JH
Ra
Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA.
Andrew J
AJ
Kerwin
Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA.
Michael S
MS
Nussbaum
Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA.
Marie
M
Crandall
Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA.
Jhun
J
deVilla
Department of Surgery, University of Florida College of Medicine - Jacksonville, 3rd Floor, Faculty Clinic, 653 W 8th Street, FC12, Jacksonville, FL 32209, USA.
Joseph J
JJ
Tepas
D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement; D012042:Registries; D012308:Risk Management; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D014481:United States
Adverse events; Morbidity and mortality; NSQIP; Outcomes; Quality improvement; Surgical procedures