Today, the American College of Surgeons (ACS), in association with the American Cancer Society, hosted the ACS Surgical Health Care Quality Forum Georgia, the 11th program in a series of events to drive national discussions on effective quality improvement methods that surgeons, physicians and hospitals are using to improve patient safety and reduce costs. Presenters also announced the creation of the Georgia Surgical Quality Collaborative, a statewide effort to encourage information-sharing among hospitals and utilize the ACS National Surgical Quality Improvement Program (ACS NSQIP®) to focus on improving outcomes in key areas of surgical care.
The forum also featured a panel of Georgia health care leaders and a rich discussion on how state hospitals, academic institutions, health plans and government institutions are using quality improvement programs, including ACS NSQIP, to improve patient outcomes and increase the value of health care.
"We are at a critical period in health care delivery where we have the opportunity to be leaders in bringing quality improvement programs to Georgia in an effort to benefit our patients and reduce costs," said forum co-host LaMar McGinnis, MD, FACS, past president of ACS and senior medical advisor and liaison to the American Cancer Society.
"Regulators are continuing to realize the value of using clinical outcomes data versus administrative claims data to measure and track quality," said David B. Hoyt, MD, FACS, executive director of ACS. "As CMS and others start tying these measures to value-based purchasing programs, hospitals have a reputational and financial incentive to participate in programs like ACS NSQIP to achieve better outcomes and decrease costs."
New Georgia Surgical Quality Collaborative Announced
Led by the ACS Georgia Chapter, nine hospitals have agreed to participate in a state-wide collaborative, with five additional hospitals slated to join in 2013. The goal of the collaborative is to share information from ACS NSQIP and compare surgical outcomes with each other and with other hospitals nationwide. The ACS NSQIP database collects preoperative, intraoperative and 30-day outcome variables on more than 117,000 major surgical procedures.
"This collaborative is a significant milestone to improve care for surgical patients in our state because it allows us to create a positive learning environment among all participating hospitals and work together to determine where improvement is needed most," said John Sweeney, MD, FACS, W. Dean Warren Distinguished Professor of Surgery, and chief, Division of General and Gastrointestinal Surgery, Department of Surgery, Emory University School of Medicine. "As it stands, hospitals can't fix errors if they don't know a problem exists. Examining and comparing clinical outcomes data with our peers from each corner of the state will help us move the needle to improve patient outcomes and reduce overall health care costs."
A recent study by Sweeney, et al., "Risk Factors for 30-Day Hospital Readmission among General Surgery Patients," was published in the September 2012 issue of the Journal of American College of Surgeons and showed postoperative complications drive readmissions – citing surgical site infections (SSI) as one of the biggest contributing factors (22.1 percent). Studies show that hospitals participating in ACS NSQIP prevent an average of 250-500 complications, and save 12-36 lives and $3 million per hospital, per year. With the average cost of surgical complications equaling $11,000 per occurrence, the combined potential savings of 4,500 hospitals could add up to $13-26 billion each year and a total savings of $260 billion over a period of 10 years.
Forum Presenters Discuss Benefits of Quality Programs
Keynote speaker Kenneth E. Thorpe, PhD, Robert W. Woodruff Professor and chair, Department of Health Policy and Management, Rollins School of Public Health, and executive director, Emory Institute for Advanced Policy Solutions, spoke about the "bigger picture" of health care quality improvement stating, "while surgical quality and outcomes are clearly key drivers for health reform and cost, focusing on evidence-based care coordination models and chronic disease prevention will also be critical to managing quality improvement and cost-containment moving forward. For example, chronic disease accounts for 84 percent of health care spending, and those patients also have high rates of preventable hospital admissions and readmissions."
Additional forum presenters commented on proven quality programs that are making an impact on patient outcomes and health care costs in local hospitals and nationwide, including:
Ryan Fagan, MD, MPH, Medical Epidemiologist, Centers for Disease Control and Prevention(CDC), Surveillance Branch, Division of Healthcare Quality Promotion
"Earlier this year, the CDC teamed up with ACS to more closely analyze infectious and non-infectious complications that affect surgical patients. By marrying infection information that hospitals report to the CDC National Healthcare Safety Network (NHSN) with ACS NSQIP measures, and leveraging electronic health records, we will be able to effectively target and prevent SSI and related complications."
Carl R. Boyd, MD, FACS, General/Critical Care Surgeon, Memorial Health University Medical Center; and Professor of Surgery,Mercer University School of Medicine
"What we have seen here at Memorial Health is that NSQIP offers risk adjusted, stringently defined, statistically powerful, nationwide, verifiable data that surgeons can believe in and will respond to. The measurable improvement in complication rates seen with a standardized approach utilizing proven best practices will lower the cost of care, but more importantly, will result in preventable pain and suffering for the patient."
Otis Webb Brawley, MD, FACP, Chief Medical and Scientific Officer, Executive Vice President, American Cancer Society; Professor of Hematology, Oncology, and Medicine, Emory University School of Medicine; and Professor of Epidemiology, Emory Rollins School of Public Health
"Improving the health care system will require equal resolve by physicians and patients to access and utilize information in order to make rational care decisions. We, as physicians, also need to address variations in care and begin standardizing more treatment protocols, including post-operative medical therapies for cancer patients."
Ana Pujols McKee, MD, Executive Vice President and Chief Medical Officer, The Joint Commission
"The Joint Commission's Center for Transforming Healthcare has worked with ACS and seven other institutions to reduce superficial incisional SSI by 45 percent and all types of colorectal SSI by 32 percent. Participating hospitals have saved more than $3.7 million by avoiding 135 infections and decreasing the average hospital stay over a two-and-a-half year period."
Bryant W. Wilson, MD, FACS, General Surgeon, Piedmont Healthcare
"NSQIP offers our surgeons valuable information on the quality of our care. But more importantly, the program has given our surgeons a tremendous opportunity to come together, as a group, to improve the care of our patients."
Following the introductory presentations, Bruce Feinberg, DO, vice president and chief medical officer of Cardinal Health Specialty Solutions, and host of The Weekly Check-Up on WSB Radio in Atlanta, moderated a lively panel discussion with additional health care experts representing health plans/payers, purchasers and hospitals, including: Jerry Dubberly, PharmD, MBA, chief, Medicaid Division, Georgia Department of Community Health; Alexandra Leopold, regional vice president, provider engagement and contracting, BlueCross BlueShield of Georgia; Dane C. Peterson, MBA, chief executive officer, Emory Hospital Midtown; and Karen Waters, RN, MHA, MBA, senior vice president, professional services and strategic planning, Georgia Hospital Association.
American College of Surgeons