A unique collaborative of Tennessee surgeons, hospitals, and insurers, established in 2008 to share data, compare results, and improve outcomes, said it came up with impressive results to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) National Conference in New York City this week.
Ten hospitals in the Tennessee Surgical Quality Collaborative (TSQC), including Erlanger Health System, the first Tennessee hospital to join the NSQIP and then participate in the collaborative, have reduced surgical complications by 19.7 percent since 2009, resulting in at least 533 lives saved and $75.2 million in reduced costs, officials said.
“It’s rare for three major stakeholders in healthcare—hospitals, surgeons, and insurers—to work together on measuring and improving the quality of surgical care in hospitals, but that’s exactly what the collaborative has accomplished,” explained Joseph B. Cofer, MD, FACS, of University Surgical Associates, and one of the authors of the study. “We also discovered that Tennessee hospitals have not only improved care, but sustained those improvements over time.”
Between 2009 and 2012, ten TSQC hospitals collected clinical, 30-day outcomes data on more than 55,000 surgical procedures, and researchers examined rates of 17 types of surgical complications. In 2012 another eleven Tennessee hospitals joined the TSQC.
Compared with complication rates in 2009, the 21 hospitals in the TSQC achieved 19.7 percent fewer postoperative occurrences, and the postoperative mortality rate dropped 31.5 percent. Hospitals prevented an estimated 3.75 deaths per 1,000 surgical procedures and avoided $75.2 million in excess costs. The collaborative saw improvements in 13 of the 17 types of complications, and nine improved significantly, including surgical site infections, pneumonia, and urinary tract infections.
A study published in the Journal of the American College of Surgeons in 2012 showed the initial 10 TSQC members reduced complication rates and saved more than $8 million in excess costs from 2009 to 2010. This new study shows TSQC hospitals continued to improve in the years after the program was launched.
The hospital collaborative is a partnership of the Tennessee Chapter of the American College of Surgeons and the Tennessee Hospital Association’s (THA) Center for Patient Safety, with support from Blue Cross Blue Shield’s Tennessee Health Foundation.
“The TSQC has helped align the efforts of hospitals and surgeons around quality improvement, which supports the THA board's commitment toward zero incidents of preventable harm in our state's hospitals,” stated Craig A. Becker, THA president.
Study authors include lead author, Brian Daley, MD, MBA, FACS; Joseph B. Cofer, MD, FACS; William C. Gibson, MD, FACS; Scott A. Copeland, MD, FACS; Chris Clarke, RN; William Cecil, MBA; and Barbara J. Martin, RN, MBA, CCRN.
Participating hospitals in the Tennessee Surgical Quality Initiative include:
Saint Thomas Midtown Hospital (formerly Baptist Hospital)
Baptist Memorial Hospital - Memphis
Claiborne County Hospital
Cookeville Regional Medical Center - Cookeville
Cumberland Medical Center
Erlanger Health System - Chattanooga
Ft. Sanders Regional Medical Center
Henry County Medical Center
Jackson Madison Co General Hospital
Maury Regional Medical Center
Memorial Health Care System
Methodist University Hospital - Memphis
NorthCrest Medical Center
Parkwest Medical Center – Knoxville
Regional One Health - Memphis
Saint Francis Hospital - Memphis
Saint Thomas West Hospital
Summit Medical Center
University of Tennessee Medical Center -Knoxville
Vanderbilt University Medical Center- Nashville
Wellmont Bristol Regional