Safety, quality, and the National Surgical Quality Improvement Program

Area of Science:

• Surgery
• Patient Safety
• Healthcare Quality Improvement

Background:

• The Institute of Medicine's "To Err is Human" highlighted preventable surgical errors, leading to national patient safety initiatives.
• The effectiveness of these initiatives remains uncertain due to a lack of quantitative patient safety metrics in surgery.

Purpose of the Study:

• To introduce a broader conceptual framework for patient safety in surgery.
• To present a quantitative metric for assessing patient safety initiatives in surgical care.

Main Methods:

• Leveraging 15 years of experience from the National Surgical Quality Improvement Program (NSQIP).
• Utilizing comparative, risk-adjusted outcome data.
• Analyzing data from both the Veteran's Administration and the private sector.

Main Results:

• The NSQIP provides a quantitative metric for evaluating patient safety in surgery.
• A broader framework defines patient safety as protection from all adverse outcomes, integrating it with surgical care quality.
• Adverse outcomes are primarily linked to the quality of healthcare systems.

Conclusions:

• Patient safety in surgery should be viewed within a comprehensive framework encompassing all adverse outcomes.
• Risk-adjusted outcome data serves as a crucial metric for identifying system deficiencies and enhancing patient safety.
• The NSQIP offers a valuable tool for improving surgical patient safety assessment and initiatives.