Using the Veterans Administration National Surgical Quality Improvement Program to improve patient outcomes

Leigh Neumayer, Mary Mastin, Lana Vanderhoof, Douglas Hinson

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Background. The primary goal of collecting quality assurance data is to ultimately improve patient care. The VA National Surgical Quality Improvement Program (NSQIP) provides each station with risk-adjusted morbidity and mortality data on a regular basis. This report of one medical center's use of the risk-adjusted data shows how it can be used to improve patient care. Materials and methods. Risk-adjusted surgical outcome data for Fiscal Year 1996 (FY96) was received from the NSQIP coordinating center. The Salt Lake City VA medical center was identified as a high outlier for morbidity in general surgery. Patient charts were reviewed and data analyzed to determine practice patterns and to determine if there were any provider issues. Data analysis revealed a large number of wound complications and uncovered a practice pattern of closure of contaminated wounds. Using these data and data from the literature, wound infection and disruption prevention protocols were instituted in the fall of 1997. Wound complications from January to December 1996 (preprotocol) and January to December 1998 (postprotocol) were compared using Student's t test. Results. The total number of operations in 1998 was 719 compared with 634 in 1996. Superficial wound infections dropped from 3.6 to 1.7%, while overall wound complications dropped from 5.5 to 2.9%. None of these changes were statistically significant. Conclusions. Although introduction of wound infection and disruption prevention protocols did not result in a statistically significant decrease in wound complication, it did result in a clinically significant improvement in patient care.

Original languageEnglish (US)
Pages (from-to)58-61
Number of pages4
JournalJournal of Surgical Research
Volume88
Issue number1
DOIs
StatePublished - Jan 2000
Externally publishedYes

Keywords

  • Quality improvement
  • Risk-adjusted outcomes
  • Surgical wound infection

ASJC Scopus subject areas

  • Surgery

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