American College of Surgeons and Houston Health Care Leaders Host Forum to Discuss Proven Ways of Improving Quality and Reducing Health Care Costs

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Sep 11, 2012, 12:14 ET

Congresswoman Sheila Jackson Lee Applauds American College of Surgeon's Leadership in Education, Training, and Surgical Quality Improvement

CHICAGO, Sept. 11, 2012 /PRNewswire-USNewswire/ -- Yesterday the American College of Surgeons (ACS) hosted more than 80 health care leaders at the ACS Surgical Health Care Quality Forum Houston to discuss how programs focused on surgical quality and education can reduce patient complications and readmissions, resulting in lower costs and greater health care value.

Area leaders representing institutions of the Texas Medical Center (TMC) – the world's largest hub for medical care and innovation – highlighted the influence of rigorous medical skills training and proven surgical quality programs on the overall state of health care in Texas and across the nation, using programs such as the Methodist Institute for Technology, Innovation, and Education (MITIE ^SM) and the ACS National Surgical Quality Improvement Program (ACS NSQIP^®) as proven models of success.

"As surgeons get deeper into practice our outcomes are only as good as we are – and continue to be – as new procedures and technologies are introduced that can make a considerable difference for patients," said forum co-host Barbara Lee Bass, MD, FACS, John F. and Carolyn Bookout Distinguished Endowed Chair of Surgery, The Methodist Hospital, executive director of MITIE, professor of surgery, Weill Cornell Medical College, and former ACS Regent. "MITIE is a unique program designed to help surgeons 're-tool' their skills to stay on top of and safely deploy innovative technologies that will allow us to deliver better care."

The forum featured remarks from keynote speaker U.S. Congresswoman Sheila Jackson Lee (D-TX18), who encouraged members of the Houston surgical and health care communities to work with lawmakers to inform important health policies moving forward.

"I commend the American College of Surgeons as well as the Texas Medical Center for their leadership and proactively taking steps to improve quality for patients throughout Texas," said Congresswoman Jackson Lee. "It is crucial that we are partners together and that policymakers have more give and take with physicians in order to understand how best to improve."

"It's critical that the clinical teams on the front lines of patient care are engaged in the important dialogue around improving quality," said forum co-host H. Randolph Bailey, MD, FACS, chief of the division of colon and rectal surgery, The Methodist Hospital, professor of surgery, Weill Cornell Medical College, University of Texas Health Science Center, and ACS Regent. "We know what works, and what doesn't work. If we aren't part of the discussion and sharing knowledge with our colleagues and policy leaders in Washington, then we can't be part of the solution."

The forum was part of the ACS Inspiring Quality initiative to drive national discussion around critical elements required for successful quality improvement programs. Preventing a medical complication – which can raise the median cost of hospitalization for major surgical procedures up to five-fold(1) – avoids additional expenditures including longer hospital stays and readmissions.

ACS NSQIP, a leading model for outcomes-based surgical quality improvement, collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database. A study published in the Annals of Surgery in 2009 determined that hospitals participating in ACS NSQIP prevented 250-500 complications, resulting in an average of 12-36 lives saved per hospital, per year. With the average cost of medical complications equaling $11,000 per occurrence, the combined potential savings of 4,500 hospitals could add up to $13-26 billion each year, amounting to an estimated total savings of $260 billion over a period of 10 years.(2)

"Health care organizations need to do everything within their power to become safe, effective and high-reliability operations," said panelist M. Michael Shabot, MD, FACS, FCCM, FACMI, system chief medical officer, Memorial Hermann Healthcare System, Houston. "Memorial Hermann is working to achieve this goal with close attention to performance metrics and by using all the College's programs and accreditations, including the ACS NSQIP, Bariatric and Trauma data registries, and Bariatric, Trauma Center and Commission on Cancer certifications. The ACS Surgeon Specific Registry is also useful for individual surgeons to monitor personal performance."

Using ACS NSQIP to compare their results with hospitals nationwide, participating hospitals are able to identify areas where they may be underperforming and develop clinical performance improvement initiatives, as well as foster and improve internal education.

"There is a real science behind creating a quality improvement team. One critical element is working closely with all of the providers and sharing quality assessment feedback regularly," said panelist Thomas A. Aloia, MD, FACS, assistant professor of surgical oncology, program director, AHPBA Hepato-Pancreato-Biliary Surgery Fellowship, University of Texas M.D. Anderson Cancer Center, Houston.

"Because quality improvement programs are used to safeguard patient care, it is crucial that quality improvement data is peer-reviewed and physician-driven," said panelist Kenneth L. Mattox, MD, FACS, distinguished service professor, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, chief of staff/chief of surgery, Ben Taub General Hospital, Houston. "Physicians, surgeons and nurses need to be the major overriding voice in their institution when quality improvement protocol is being established."

"When done correctly, outcomes or comparative effectiveness research using population-based data such as ACS NSQIP can play a critical role in the quality improvement process at the local, regional, and national level," said panelist Taylor S. Riall, MD, PhD, FACS, John Sealy Distinguished Chair in Clinical Research, Director, Center for Comparative Effectiveness and Cancer Outcomes, associate professor, department of surgery, University of Texas Medical Branch, Galveston.

Just as all quality improvement is local, not all measurement is created equal, specifically in pediatric surgery. The ACS NSQIP Pediatric program, while still in its infancy, is helping to support quality improvement in Children's hospitals.

"ACS NSQIP Pediatric is important because it provides risk-adjusted outcomes data that children's hospitals can use for comparison – something that often is difficult to do because of the infrequent nature of health problems among pediatric patients," said panelist Kevin P. Lally, MD, MS, FACS, A.G. McNeese Chair in Pediatric Surgery, Richard Andrassy Distinguished Professor, professor and chairman, department of pediatric surgery, University of Texas Health Science Center, Houston. "As with the adult ACS NSQIP, if there are national reporting standards that are based on ACS NSQIP, hospitals will use it."

Throughout the program, one key theme was front and center: physicians must be highly involved in the pursuit of quality improvement – whether it be leading the charge with their institutions to implement programs like NSQIP, or working with their patients to encourage healthy lifestyle choices which ultimately results in better health outcomes.

"Our country is seeing a changing paradigm from 'sickness care' to 'health care,' and in order to expedite this transition we need to equip people with the tools and education necessary to keep themselves healthy so we can focus resources on conditions that are largely unpreventable," said panelist Richard E. Wainerdi, PE, PhD, president and chief executive officer, Texas Medical Center, Houston. "I see great opportunity for surgeons to become engaged leaders in their local communities and help drive this type of quality improvement as well."

To further encourage community-level health care leaders to share best practices on quality improvement, the ACS will continue to host a series of community forums across the nation throughout 2012. To view the archived forum video and follow updates on upcoming tour locations, please visit InspiringQuality.FACS.org or the College's YouTube channel at http://www.youtube.com/AmCollegeofSurgeons.

About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 78,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

(1) Rowell, KS, et al. "Use of National Surgical Quality Improvement Program Data as a Catalyst for Quality Improvement." Journal of the American College of Surgeons. 204 (6): 1293-1300; June 2007.
(2) Hall BL, Hamilton BH, Richards K, et al. Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals. Ann Surg 2009;250:363–376.

SOURCE American College of Surgeons