Quality improvement in surgery: introduction of the American College of Surgeons National Surgical Quality Improvement Program into New South Wales.

Abstract

Quality improvement in surgery requires accurate, reliable, risk-adjusted and comparative data. The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) takes reliable clinical data and provides risk-adjusted comparisons with more than 800 hospitals. This paper describes the early outcomes of introducing this programme into New South Wales (NSW). Four NSW hospitals formed a collaborative. Surgical clinical reviewers were trained and data collected. Risk-adjusted reports were returned to individual hospitals and the NSW Collaborative. The results identified that the NSW Collaborative were outliers for the following causes of morbidity: urinary tract infections, surgical site infections, pneumonia and 30-day readmissions. We have shown that ACS-NSQIP can be adapted to Australia and there is a plan to widen the programme in NSW.