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Quality Assessment and Safety Committee Initiatives

Quality Assessment and Safety Committee Initiatives | ASCRS

Best Hospitals by Specialty National Rankings

With the rapid growth of online users there are only a few resources that have maintained a reputation as honest brokers in the evaluation of quality. In the domain of healthcare delivery the US News and World Report (USNWR) rankings occupy a unique space and their annual evaluation of hospitals is widely recognized and coveted. Quantifying the quality of care delivered by a hospital, however, is no small feat. The goal of this brief communication is to provide a succinct summary of the approach used by the USNWR to generate its evaluations.

Reducing Surgical Site Infection – Where do I look?

Surgical site infections are classified into three categories based upon the location and depth of infection.  These include superficial, deep and organ surgical site infections. The classification system most commonly used is based upon that published by Horan et al in 1992, and this system is the basis for that used by the Centers for Disease Control (CDC), the National Healthcare Safety Network, and the National Surgical Quality Improvement Program (NSQIP).

The American Society of Colon and Rectal Surgeons (ASCRS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. ASCRS takes responsibility for the content, quality and scientific integrity of this CME activity.

This enduring material is FREE and is eligible for 1 AMA PRA Category 1 Credit™.

Traditionally, a successful operation has been defined via discrete clinical outcomes, such as wound infection, oncologic completeness, or mortality.  However, the patient’s definition of success, and thus their satisfaction with the outcome, may differ from his or her surgeon’s.  Patient Reported Outcomes (PROs) evaluate outcomes from a patient’s perspective and generally require dedicated measurement instruments.  PROs can be used for clinical care, quality improvement, research and may at some point be used for payment.

Cancer Survivorship Care

Survivorship care is increasingly recognized as an important element of cancer treatment. The Commission on Cancer and the American College of Surgeons are actively promoting survivorship, using the Commission on Cancer accreditation process as a lever.  Integrating survivorship care into a multi-disciplinary cancer program is pragmatically challenging, but appropriate integration with an EMR may smooth this transition.

The Quality and Safety Committee developed the Cancer Survivorship Care overview to provide details on survivorship care plans and resources.

Rectal Cancer Overview

In the treatment of rectal cancer, colorectal surgeons exercise the greatest amount of clinical judgment, and work with the broadest range of other medical specialties. The Quality Assessment and Safety Committee covers several important, trending topics in the area of rectal cancer treatment, from the perspective of quality and patient safety.

Enhanced Recovery Overview

Currently, all parties – patients, payers, and providers are motivated (for different reasons) to optimize the speed and safety of patient recovery after abdominal surgery.  The clinical and economic costs associated with delayed or sub-optimal recovery are staggering.  Within the US, the costs associated with post-operative ileus alone are estimated at $1.5 billion per year. [1] Clearly, strategies that target and enhance post-operative recovery are worth consideration.
 
Significant improvements in recovery after major abdominal surgery can be achieved by implementing a standardized protocol of evidence-based treatments over the entire peri-operative period.  The Quality and Safety Committee developed the Enhanced Recovery Overview to highlight possible complications and treatments related to enhanced post-operative recovery.  

Rectal Cancer Safety Checklist

Use of checklists has been demonstrated to improve the quality and safety of surgical care. To improve the standardization and quality of care of rectal cancer by our membership, the Quality Assessment and Safety Committee of the ASCRS developed a checklist for rectal cancer surgery which was iteratively revised by committee. The ASCRS Rectal Cancer Safety Checklist can be used to (1) raise awareness of rectal cancer guidelines; (2) enhance pre-operative, intra-operative, and post-operative documentation; and (3) facilitate integration of best practices into pre-operative cancer conferences. ASCRS members who attended the annual meeting in Vancouver provided many positive and constructive comments that were incorporated into the finalized version of the checklist. We welcome feedback on its use at ascrs@fascrs.org

  

National Activities of the Quality and Safety Committee

National Quality Forum (NQF):

The ASCRS Quality Assessment and Safety Committee has successfully nominated members to NQF Surgery Measures Steering Committee, the Consensus Standards and Approval Committee, and several related measurement evaluation and endorsement committees.

Surgical Quality Alliance (SQA)

 

Links to National Quality/Policy Initiatives & Conferences

NSQIP  NSQUIP Website Virtual Tour

ACS (advocacy/Nora Patient safety)


Committee Updates

Rectal Cancer Committee Update
 

Fact Sheets