American College of Surgeons and Philadelphia Health Care Leaders Discuss Physician-Led Quality Improvement Initiatives

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Oct 12, 2012, 05:09 ET

U.S. Representative Jim Gerlach (R-PA6) applauds local efforts to improve patient outcomes, emphasizes role of quality improvement in shaping health care reform

CHICAGO, Oct. 12, 2012 /PRNewswire-USNewswire/ -- Today the American College of Surgeons (ACS) held the ACS Surgical Health Care Quality Forum Philadelphia, the ninth 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.

The Philadelphia forum focused on the importance of physician-led quality improvement initiatives in sustaining better outcomes, using the ACS National Surgical Quality Improvement Program (ACS NSQIP^®) as a leading and successful model giving surgeons reliable data to help pinpoint areas for improvement.

"We're all faced with the challenges of navigating a complex and ever-changing health care system," said Marshall Z. Schwartz, MD, FACS, professor of surgery and pediatrics at Drexel University College of Medicine, pediatric surgeon-in-chief at St. Christopher's Hospital for Children, member of the ACS Board of Regents, and event co-host. "The good news is we don't have to re-invent the wheel to achieve the level of quality improvement and cost savings we need for health reform to be successful."

"Using proven quality improvement methods like ACS NSQIP is a perfect example of what we, as physicians, can do together to support health reform," added Howard M. Snyder III, MD, FACS, attending urologist at Children's Hospital of Philadelphia, professor of urology in surgery at the University of Pennsylvania School of Medicine, member of the ACS Board of Regents, and event co-host.

The forum featured remarks from keynote speaker U.S. Congressman Jim Gerlach (R-PA6), an influential member of the House Ways and Means Committee, who cited parallels between the government's health care reform efforts and quality improvement programs such as ACS NSQIP, which collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database. He also addressed the need to better link higher quality to reimbursement.

"The mission of the Ways and Means Committee right now is to prevent the 27 percent cuts in Medicare reimbursement and extend it until we can come up with a proper formula for reimbursing physicians," said Congressman Gerlach. "You [surgeons] bring a credibility and knowledge that legislators don't have and I would encourage you to advocate for these changes we need to have and the programs you want to save because they work."

The 'proof is in the pudding' when it comes to surgical quality programs that are leading to better patient outcomes and reduced costs in hospitals. A 2009 study published in the Annals of Surgery determined that hospitals participating in ACS NSQIP each prevented 200-500 complications annually and saved an average of 12-36 lives per year by reducing complications. 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.(1)

Having a keen focus on surgical outcomes with an end goal of reducing complications is nothing new to the panel of state experts.

"Pennsylvania was the first state to publicly report hospital-acquired infections and that transparency has improved the appetite for quality improvement programs in our state and around the country," Larry R. Kaiser, MD, FACS, senior executive vice president for health services, dean, Temple University School of Medicine; president and chief executive officer, Temple University Health System. "Surgeons trust and embrace clinical data which is why The Society of Thoracic Surgeons (STS) National Database and ACS NSQIP have been successful tools to reduce complications and improve patient care."

"For ten years, Geisinger has focused on an intervention framework to identify variation in care and re-engineer best practices, resulting in decreased costs and improved quality," said Glenn D. Steele Jr., MD, Ph.D., FACS, president and chief executive officer, Geisinger Health System. "Surgery departments present a clear opportunity to define complications and implement and assess solutions, as there is a distinct starting and end point to support accurate measurement."

Beyond improving patient care and reducing costs, ACS NSQIP is a valuable source of trusted information that is leveraged by surgeons to compare themselves with their colleagues and that can be used by individuals who are hungry for information to differentiate hospital care in their community.

"Using a program like ACS NSQIP allows us to benchmark ourselves against our colleagues as well as other hospitals across the country and create a national standard," said John S. Kukora, MD, FACS, FACE, chairman, department of surgery, program director, general surgery residency program, Abington Memorial Hospital. "This [type of] reporting isn't just for surgeons and hospital administrators – it can also inform consumers' choices as they are armed with knowledge and can choose a hospital based on its performance record."

While much of the panel focused on the profession's quality improvement successes, one panelist pointed out ways to better study and measure the successes of ACS NSQIP in hospitals around the country.

"From a business school perspective, continuous quality improvement [CQI] is a good idea in theory but rarely works in practice," said Mark V. Pauly, Ph.D., Bendheim Professor, professor of health care management, professor of business economics and public policy, The Wharton School, University of Pennsylvania. "However, based on what I've seen thus far, I'm encouraged to believe ACS NSQIP is an exception to the rule, though more empirical evidence comparing outcomes data between hospitals with the program and those without is needed to convince health economists that CQI can be effective."

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) 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