Up close and personal: A statewide collaborative's effort to get individual surgeon quality improvement data to the practitioner

Brian Daley, William Cecil, Joseph B. Cofer, P. Chris Clarke, Oscar Guillamondegui

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Ranking of surgeons and hospitals focuses on procedure volume and hospitality. The National Surgical Quality Improvement Program provides vetted outcomes of surgical quality and therefore can direct improvement. Our statewide collaborative's analysis creates personalized surgeon data to drive quality improvement. Statewide National Surgical Quality Improvement Program data generated specific measures from 103,656 general/vascular cases and identified individual surgeon's outcome of occurrences and length of procedure.We assumed a normal distribution and called the top 2.5 per cent as exemplars and the bottom 2.5 per cent as outliers. For length of operation, a standard duration was calculated, and identified outliers as longer than the 95th percentile of the upper confidence interval/procedure. Since 2009, sharing best practice reduced statewide mortality rate by 31.5 per cent and postoperative morbidity by 33.3 per cent. For length of surgery, long outliers have more complications (urinary tract infection, organ space/surgical site infection, sepsis, septic shock, prolonged intubation, pneumonia, deep venous thrombosis, deep incisional infection, and wound disruption). No significant trends in surgeon performance were seen over 24 months. A statewide collaborative has resulted in substantial risk-Adjusted reductions in surgical morbidity and mortality. These results of the individual surgeon demonstrate best practices are shared, a proven tool for improvement in our collaborative.

Original languageEnglish (US)
Pages (from-to)192-198
Number of pages7
JournalAmerican Surgeon
Volume82
Issue number3
StatePublished - Mar 1 2016

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Quality Improvement
Practice Guidelines
Morbidity
Surgical Wound Infection
Mortality
Normal Distribution
Wound Infection
Risk Reduction Behavior
Septic Shock
Intubation
Urinary Tract Infections
Venous Thrombosis
Blood Vessels
Sepsis
Pneumonia
Surgeons
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Up close and personal : A statewide collaborative's effort to get individual surgeon quality improvement data to the practitioner. / Daley, Brian; Cecil, William; Cofer, Joseph B.; Clarke, P. Chris; Guillamondegui, Oscar.

In: American Surgeon, Vol. 82, No. 3, 01.03.2016, p. 192-198.

Research output: Contribution to journalArticle

Daley, Brian ; Cecil, William ; Cofer, Joseph B. ; Clarke, P. Chris ; Guillamondegui, Oscar. / Up close and personal : A statewide collaborative's effort to get individual surgeon quality improvement data to the practitioner. In: American Surgeon. 2016 ; Vol. 82, No. 3. pp. 192-198.
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