Related Experiment Video
Updated: Jun 9, 2025

Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
How Well Are Surgical Quality Improvement Projects Planned? Review of 242 Surgical Improvement Efforts Across 5
Tejen A Shah1,2, Xane D Peters1,3, Shelbie D Waddle4,5
1From the Division of Research and Optimal Patient Care (Shah, Peters, Valek, Modla, Pollitt), American College of Surgeons, Chicago, IL.
Background:
Structured preparation is necessary to conduct quality improvement (QI) strategies that are relevant to the problem, feasible, appropriately resourced, and potentially effective. Recent work suggests that improvement efforts are suboptimally conducted. Our goal was to determine how well preparation for surgical QI is undertaken, including detailing the problem, setting project goals, and planning an intervention.
Study Design:
This retrospective cross-sectional study included QI efforts submitted in 2019 to the American College of Surgeons (ACS) during review for accreditation across 5 ACS Quality Programs: Children's Surgery Verification, the Commission on Cancer, the MBSAQIP, the National Accreditation Program for Breast Centers, and the Trauma Verification Program. Projects were scored for alignment with three components of the preconduct phase of the ACS Quality Framework: problem detailing, goal specification, and strategic planning.
Results:
A total of 242 projects satisfied inclusion criteria and were scored. Most projects in the final cohort were from MBSAQIP (36%), Commission on Cancer (31%), or National Accreditation Program for Breast Centers (29%) programs. The average overall preconduct score was 52% (SD 17). On average, projects performed best in the "goal specification" component (65%, SD 27), followed by "problem detailing" (52%, SD 16), and "strategic planning" (44%, SD 25). Within these components, identification of possible limitations (5%) and consideration of contextual issues (12%) were among the least frequently reported items.
Conclusions:
Thorough planning is a critical component of effective QI, and our study reflects significant opportunity for its improvement. The ACS Quality Framework may serve as a guide to improve QI planning, thereby promoting efficiency and effectiveness of these efforts.
More Related Videos
Related Concept Videos
Planning Nursing Care I
Quality Assurance
Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
Acute Coronary Syndrome IV: Interprofessional Care
Peripheral Artery Disease V: Postoperative Nursing Management

