Improved surgical outcomes are not related to the use of systems which capture and report postoperative metrics. Hospitals which participate in the National Surgical Quality Improvement Program (NSQIP) did not differ from non-NSQIP hospitals in terms of better surgical outcomes, according to Mayo Clinic researchers. The report appears in the Journal of the American Medical Association.
"In our study we weren't interested in whether patients had better outcomes in NSQIP vs. non-NSQIP hospitals," said study author David Etzioni, MD, chair of Colorectal Surgery at Mayo Clinic in Arizona. "We wanted to know whether the outcomes experienced by patients treated at NSQIP hospitals improved, over time, in a way that was different from patients treated at non-NSQIP hospitals.”
The researchers examined data from 345,000 patients who were treated at academic hospitals in the US between 2009 and 2013. Specifically, they analysed data pertaining to surgical complications and mortality. About half of the patients were treated in facilities which participated in NSQIP, which is the most widely used system for reporting surgical outcomes and is coordinated by the American College of Surgeons.
Outcomes Improve Overall
Surgical outcomes improved for both groups of hospitals during the four-year study period. However, there was no evidence that the improvements for patients treated in the hospitals which participated in NSQIP differed from those treated in non-NSQIP facilities. The authors suggest that the absence of improvements that are clearly related to the use of an outcome monitoring system could be due to challenges in identifying those mechanisms of the system which “translate” the reports into measurable changes in surgical care.
Dr. Etzioni said, “I think if there is one lesson that we have learned at Mayo Clinic; real quality is achieved through a system -- not just a doctor, not just a nurse or other staff. All of these elements of care have to work together closely to provide patients with the best possible outcomes.”
Source: Mayo Clinic
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