The Power of the National Surgical Quality Improvement Program—Achieving A Zero Pneumonia Rate in General Surgery Patients

TLDR

NSQIP offers risk‑adjusted outcome metrics that hospitals use to improve surgical mortality and morbidity. The article reviews NSQIP’s history and demonstrates how its outcome reports can drive performance improvement, using postoperative respiratory complications as an example, and outlines a collaborative playbook for hospitals. NSQIP collects 135 clinical variables per patient, compiles biannual mortality and complication reports, and applies these data to drive performance improvement, exemplified by postoperative respiratory complications, and supports collaborative playbook development.

Abstract

The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year. This article summarizes briefly the history of NSQIP and how its report on surgical outcomes can be used for performance improvement within a hospital system. In particular, it describes how to drive performance improvement with NSQIP data using the example of postoperative respiratory complications--a major factor of postoperative mortality. In addition, this article explains the benefit of a collaborative of several participating NSQIP hospitals and describes how to develop a "playbook" on the basis of an outcome improvement project.