ACS Surgical Quality Improvement Program Linked to Better Colorectal Surgery Outcomes

Complications stemming from colorectal surgery decreased after introducing a national quality improvement program, results of a new study by P. Ravi Kiran, MD, FRCS, FACS, FASCRS, indicate.

"This is one of the few studies to evaluate whether the introduction of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) has improved postoperative outcomes over time," explained Dr. Kiran, head of Colorectal Surgery Division at Columbia University.

The ACS NSQIP® is an outcomes-based program to measure and improve the quality of surgical care created and implemented by surgeons nationwide. 

After analyzing data from 301,632 patients from 2007 to 2016, Dr. Kiran and team noted several key improvements in colectomies, including a 9% decrease in surgical site infections (SSIs) and a nearly 40% increase in early discharges.

Dr. Kiran attributed the improved outcomes to several factors:

  • Using NSQIP national data allows surgeons to benchmark and compare outcomes with peers and identify areas for improvement
  • Participating in the NSQIP encourages providers to follow evidence-based recommendations for decreasing SSIs and more quickly and safety getting patients through the acute postoperative phase and back at home
  • Development of procedure-targeted datasets so participants can report additional, optional data specific to an operation

Dr. Kiran and team divided up the NSQIP data into groups: resection procedures before (n=131,122) and after (n=179,510) introduction of colectomy-targeted dataset into practice. 

Controlling for potentially influential factors – including differences in surgical technique – the authors found the introduction of colectomy-targeted data was linked to a 22% risk reduction of SSIs, 30% decrease in the odds of developing a urinary tract infection, and a 12% decrease in the need for reoperation.

“The reduced odds of experiencing a complication likely translate to hundreds of complications said each year,” said Dr. Kiran. For patients, and referring physicians looking to find the best colorectal surgery care, Dr. Kiran suggests that patients find hospitals who participate in the ACS NSQIP® to ensure commitment to the best outcomes, nationwide. 

Dr. Kiran presented his findings at the 2018 American College of Surgeons 2018 Clinical Congress held in Boston, Massachusetts.