ACS NSQIP Tools for Success National Conference July 21, 2012
Current and Coming Tools Participant Use Data File (PUF) ROI Calculator Best Practices Guidelines Best Practices Case Studies Quality Improvement Primers Conference Presentations Online Forums Risk Calculator Surgical CUSP Hospital Compare Pilot CMS Final Rule Real Time Risk Adjustment SCR Toolkit/Surgeon Champion Toolkit Press Kit
Participant Use Data File (PUF) HIPAA compliant data file containing cases submitted to the ACS NSQIP Available for research Produced annually Available to researchers, surgeons, SCRs, etc. at currently participating institutions User guide for each PUF explains variable formats, variable definitions, and other supporting information Available in a delimited text, SAS, or SPSS file
Participant Use Data File (PUF) Requestors must agree to comply with the terms and conditions set forth in the PUF Data Use Agreement, provide contact information, and complete a short online questionnaire Information provided is received and processed by ACS NSQIP staff Once approved, requestor will receive instructions on how to download the file
Participant Use Data File (PUF) http://site.acsnsqip.org/participant use data file/
ROI Calculator Allows sites to calculate financial costs of complications Allows sites to calculate cost savings of reducing complications through participation in ACS NSQIP Complication costs determined through combination of private and public sector payor findings
ROI Calculator http://site.acsnsqip.org/about/business case/roi calculator/
ROI Calculator
Best Practices Guidelines Provide evidence based recommendations regarding the prevention, diagnosis, or treatment of post operative complications Developed by expert panel for QI purposes at participating sites Available Guidelines Prevention of Postoperative Pulmonary Complications Prevention of Catheter Associated Urinary Tract Infections Prevention and Treatment of Venous Thromboembolism Prevention and Assessment of Intravascular Catheter Related Bloodstream Infections Prevention of Surgical Site Infections Prevention of Ventilator Associated Pneumonia Prevention of Postoperative Renal Complications (in production) Optimal Properative Assessment of the Geriatric Surgical Patient (in production)
Best Practices Guidelines Accessed through the secure Workstation
Best Practices Case Studies Showcase how participating hospitals have used ACS NSQIP data to improve their performance and outcomes Allow ACS NSQIP participating sites to learn from the experiences of other hospitals and develop similar quality improvement initiatives within their own facilities Three volumes of case studies currently available
Best Practices Case Studies Accessed through the secure Workstation
Quality Improvement Primers Developed to create a framework that can be used to prioritize and direct efforts to improve perioperative outcomes Designed to serve as complete yet concise resources for health care providers and quality improvement professionals Assembled through reviews of the current literature and consultation with experts in the field Available Quality Improvement Primers: Leading and Managing Organizational Change Statistical Process Control Charts
Quality Improvement Primers Accessed through the secure Workstation
Conference Presentations Allows access to presentations presented at previous ACS NSQIP National Conferences Conference presentations can be utilized by existing sites to learn more about topics of interest Previous conference topics include improving outcomes, surgical advances, SCR tools, lessons from new and existing sites, disseminating results to hospital staff, etc.
Conference Presentations Accessed through the secure Workstation
Online Forums Participant only benefit of the ACS NSQIP that allows users to share information, learn from one another, and network Should be a friendly and informative place for program participants Users must comply with terms of use Separate discussion boards for SCRs and Surgeon Champions Not monitored by ACS
Online Forums Accessed through the secure Workstation
Risk Calculators Online tool designed to be used in conjunction with a surgeon s evaluation to help predict the risk of certain adverse events following surgery Estimates the individual patient s risk of postoperative complications based on information about the patient Provides estimates based on ACS NSQIP data of thousands of patients from hundreds of hospitals who have undergone similar surgeries Includes the hospital effect for NSQIP participants
Risk Calculators Assists physicians in the preoperative evaluation of patients by: Helping to identify what type of procedure is best for patient Heightening awareness for risks of specific complications Illuminating any need for additional preoperative workup Helping to clarify if the patient is even a candidate for surgery Presents opportunity to: Improve informed consent Provide visual aid and explanation to make patient aware of expectations of surgery Help patients decide whether or not to have surgery
Risk Calculators Colorectal Risk Calculator is available to everyone Other calculators are only available to hospitals participating in ACS NSQIP: Colecystectomy Bariatric Ventral hernia repair Other risk calculators will be developed in the future Calculators are regularly revised and updated
Risk Calculators Available to surgeons through Risk Calculator website http://riskcalculator.facs.org
Risk Calculators Input patient information
Risk Calculators Graph shows patient s risk as compared to low risk and high risk patients
Risk Calculators Patient Information Sheet can be printed to convey risk to patient as part of consent
Surgical CUSP Johns Hopkins University and ACS are partnering to develop, implement, and evaluate a program to improve surgical patient outcomes and prevent complications based on the successful Comprehensive Unit Based Safety Program (CUSP) Hospitals will work together to implement specific quality improvement initiatives, including a recognized teamwork program developed by the Department of Defense and AHRQ, and a modified version of the WHO s surgical checklist Beginning in 2012 with a pilot program involving 100 ACS NSQIP hospitals 10 hospitals in 10 states In the future, the program will be expanded nationally
Hospital Compare Pilot ACS NSQIP participating hospitals can voluntarily publicly report outcomes on CMS Hospital Compare website Hospitals can report one or any combination of three surgical measures elderly surgery outcomes, colectomy outcomes, and lower extremity bypass The Hospital Compare website will explain the rigor of ACS NSQIP data so that patients better understand what the measures mean, the importance of accurate, risk adjusted data, and how to use the information in making their care decisions ACS NSQIP hospitals can electronically sign up to participate and choose the measures on which to report
CMS Final Rule In 2011, CMS announced a new measure to encourage participation in a general surgery registry and expressed its intention to move toward reporting based on clinical data and outcome measures Hospitals participating in a general surgery registry, like ACS NSQIP, will receive additional reimbursement under value based purchasing Participating hospitals must begin collecting data by 2013 Value based purchasing incentive goes into effect ibn 2014 CMS intends to move to clinical, risk adjusted quality measures in 2015
Real Time Risk Adjustment Real time results on their outcomes in 5 NQF endorsed measures (colon, elderly, lower extremity bypass, SSI, and UTI)
SCR/Surgeon Champion Toolkits Toolkits are designed to assist SCRs and Surgeon Champions in successfully implementing and utilizing ACS NSQIP at their hospitals Online modules cover introduction of the program at the hospital, collecting data and organizing work, and disseminating results and utilizing data for QI Consisted of checklists, video testimonials, sample documents, tutorials, etc.
Press Kit Consists of ACS NSQIP approved materials that participating sites can use to inform their hospitals and the public of their participation in the program Will include press releases, posters, hospital announcements, logo use guidelines, electronic banners, etc. Will be available on www.acsnsqip.org so participating sites can easily utilize the materials
Conclusion New and innovative ways to share information and help improve outcomes Site feedback and input is essential Amy J. Hart Product Operations Manager ahart@facs.org Fareeha Shuttari Khan Program Manager fkhan@facs.org Laura Sutton Pediatric Program Manager lsutton@facs.org