Atlantic Health System’s Morristown Medical Center and Overlook Medical Center were again recognized as one of 83 participating hospitals that have achieved meritorious outcomes for surgical patient care in the American College of Surgeons’ National Surgical Quality Improvement Program (ACS NSQIP®).
The ACS NSQIP recognition program commends a select group of hospitals for achieving a meritorious composite score in either an “All Cases” category or a category which includes only “High Risk” cases. Risk-adjusted data from the July 2018 ACS NSQIP Semiannual Report, which presents data from the 2017 calendar year, were used to determine which hospitals demonstrated meritorious outcomes. Overlook Medical Center and Morristown Medical Center have been recognized on both the “All Cases” and “High Risk” Meritorious lists.
Hospitals participating in ACS NSQIP are required to track the outcomes of inpatient and outpatient surgical procedures and collect data that assess patient safety and can be used to direct improvement in the quality of surgical care.
The 83 commended hospitals achieved the distinction based on their outstanding composite quality score across these eight clinical areas: mortality, unplanned intubation, ventilator > 48 hours, renal failure, cardiac incidents (cardiac arrest and myocardial infarction), respiratory (pneumonia), SSI (surgical site infections-superficial and deep incisional and organ-space SSIs), or urinary tract infection.
How Morristown achieved a ‘Meritorious’ surgical program
“Being committed to quality means implementing strong protocols and robust processes that consistently ensure the safety of our patients,” said Rolando H. Rolandelli, MD, Chairman, Department of Surgery, Morristown Medical Center. “Some of our most effective efforts have been creating a risk mitigation strategy for wound infection prevention that other hospitals have since adopted as a best practice and reducing the time patients remain on mechanical ventilators after surgery.”
Other initiatives focused on communication, Rolandelli said.
“We have also implemented a surgical risk calculator to counsel patients and their families when surgery is risky, have added new technology for nurses to communicate with the surgical team during surgery to reduce foot traffic in the operating room and meet regularly to review our quality improvement efforts.”
How Overlook achieved a ‘Meritorious’ surgical program
“The excellence in surgery that we’ve been able to achieve is a product of greater communication among surgeons and the surgical team, sharing best practices and using data from this program to identify areas of improvement,” said Paul Starker, MD FACS, chairman of the department of surgery at Overlook Medical Center.
For example, Starker noted the addition of more specialists in high-risk and high-tech procedures, such as surgical oncology and colorectal surgery.
In the latter, Overlook this year began a program dubbed Enhanced Recovery After Surgery, or ERAS, which standardizes care for patients before, during and after surgery. It involves a multidisciplinary team in the pre-operative, surgical and post-operative settings, as well as innovations such as a fluid management system that allows the surgical team to more accurately monitor a patient’s fluid needs, thus reducing the patient’s length of stay. The program has already yielded improvements in quality.
“Standardization is the key to quality,” Starker said. “The ERAS program is applicable to many different procedures and we are exploring how to branch it out to other procedures in which we can apply that quality improvement.”
In surgical oncology, at both Morristown and Overlook, the use of fellowship-trained, board-certified surgical oncologists has been key to achieving success.
Overlook has also maintained high performance in general and bariatric surgery, which were also recently recognized by Healthgrades.
Of the 83 hospitals, 71 each were recognized on the “All Cases” list and the “High Risk” list, representing 10 percent of the 708 ACS NSQIP hospitals participating in the program in 2017. Of the 83 hospitals, 58 hospitals were recognized on both the “All Cases” and “High Risk” lists, 12 other hospitals were on just the “All Cases” list, and 13 other hospitals were on the “High Risk” list only.