Accelerating surgical quality improvement in Ontario through a regional collaborative: a quality-improvement study

Area of Science:

• Healthcare Quality Improvement
• Surgical Outcomes Research
• Health Services Research

Background:

• The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) collaborative in Ontario, the Ontario Surgical Quality Improvement Network (ON-SQIN), was launched in January 2015.
• This initiative aimed to support and examine the early impact of surgical quality improvement on member hospitals.

Purpose of the Study:

• To describe the approaches used by ON-SQIN to support surgical quality improvement.
• To examine the early impact of the ON-SQIN on participating Ontario hospitals.

Main Methods:

• Included all Ontario hospitals participating in ON-SQIN and NSQIP.
• Primary intervention: introduction of ON-SQIN.
• Secondary interventions: community of practice, access to quality improvement resources and tools. Outcome measures included quality improvement capacity, postoperative complications, and infection rates.

Main Results:

• Eighteen hospitals reported increased quality improvement capacity after 18 months.
• Analysis of 14,748 surgical cases showed reduced acute renal failure (RR 0.48) and urinary tract infections (RR 0.77).
• Most hospitals reported reductions in surgical site and urinary tract infections over one year.

Conclusions:

• ON-SQIN facilitated NSQIP adoption and targeted quality improvement initiatives in Ontario.
• The network enhanced quality improvement capacity and fostered a community of practice.
• Early findings indicate improvements in surgical care are being achieved.