Emory Surgery NSQIP Celebration: 10,000 Lives Strong

November 2018

Dr. John Sweeney

John Sweeney

Built by surgeons for surgeons, the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) is a nationally validated, risk-adjusted, outcomes-based program that provides participating hospitals with tools, analyses, and reports to make informed decisions about improving quality of care. The program has proven to be highly effective in assisting its members in enhancing the quality of their surgical care while also reducing complications and costs.

In recognition of Emory University Hospital's (EUH) decade of membership in ACS NSQIP, followed by Children's Healthcare of Atlanta's (CHOA) participation since 2010, and Emory University Hospital Midtown's (EUHM) since 2015, "Emory Surgery NSQIP Celebration: 10,000 Lives Strong" was held on November 13, 2018, at the Miller Award Alumni House.

The broad cross section of Emory School of Medicine and Emory Healthcare professionals that attended the event was an appropriate tribute to the multidisciplinary team approach that made it possible for many of the Emory Department of Surgery's ACS NSQIP-associated initiatives and efforts to achieve their goals throughout the years, particularly the ultimate aims of lowering patient readmissions and overall mortality, resulting in such kudos as EUH being recognized by NSQIP for having meritorious outcomes in surgical patient care in 2017.

Dr. William Bornstein

William Bornstein

The three featured speakers were William Bornstein, MD, PhD, chief medical officer and chief quality and patient safety officer for Emory Healthcare, John Sweeney, MD, chair of Emory Surgery, and Joe Sharma, MD, EUH's NSQIP champion and Emory Surgery's chief quality officer.

Dr. Sweeney and Dr. Bornstein focused on the history of NSQIP, which was initially developed in the 1990s by the U.S. Department of Veterans Affairs to upgrade the quality of care in its hospitals. After observing improved operative outcomes, the VA launched a pilot study at EUH, Michigan Medicine Hospital, and Kentucky's Albert B. Chandler Hospital to determine if NSQIP could be useful in private hospitals as well. The answer was yes, and in 2000, the ACS initiated its own pilot NSQIP program, and began enrolling additional hospitals in 2004. Under the direction of Dr. Sweeney, then Emory Surgery's chief of quality, EUH joined ACS NSQIP in 2009.

Dr. Sharma, who became the steward of EUH's partnership with NSQIP, described overseeing the collection of patient data from EUH's general, plastics, oncology, colorectal, endocrine, and critical care service lines, and the submission of 30-day outcomes and other categories from this gradually accreting data to NSQIP. The phrase "10,000 Lives Strong" refers to this patient database, which has now grown to containing information from almost 13,000 cases amassed from EUH, Egleston, and EUHM, and is an essential source for acquiring the risk-adjusted and benchmarked outcomes that fuel Emory Surgery's ongoing improvement efforts.

Dr. Joe Sharma

Joe Sharma

Dr. Sharma then reviewed the number of adverse outcomes prevented at each facility in numerous categories after enacting NSQIP-influenced improvements, and enumerated several of the successful improvement projects that evolved from analyses of NSQIP's benchmarked data, including lowering the incidence of surgical site infections, preventing urinary tract infections, reducing post-operative incidence of pneumonia, decreasing complications after colorectal surgery, and lessening patient time on the ventilator in the ICU.

After announcing ACS NSQIP's ranking of EUH as a meritorious performing hospital and reading from a congratulatory letter sent by Clifford Y. Ko, MD, director of the division of research and optimal patient care of the ACS, who cited EUH "as one of the original ACS NSQIP hospitals" and praised Emory for being "a leader in surgical quality," Dr. Sharma concluded the formal portion of the celebration with a call to action for expanding NSQIP investment to clinical providers throughout Atlanta and the state of Georgia.

"We must take the momentum that exists right now, and use it to expand the NSQIP relationship throughout the city and beyond," he said. "The most logical places to start are the remaining institutions in our own backyard: Emory Saint Joseph's Hospital, Emory Johns Greek Hospital, and Grady Memorial Hospital. As this process has developed and continues to do so, we have all learned that partnering with NSQIP benefits all stakeholders, most importantly our patients and their families."

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