Surgery: Safety & Quality

Surgery

The Department of Surgery at Stamford Health is committed to patient safety and providing services that are of the highest quality. A broad range of efforts are in place to achieve these goals. Our commitment to quality begins with an interdisciplinary team approach, led by the Department Chair, Kevin Dwyer, MD, a national expert in Surgical Oncology, and Vice Chair, Michael Ebright, MD, head of departmental Quality Improvement and a national leader in Trauma services.

The Department of Surgery and Perioperative Services has instituted a Culture of Safety Committee charged with continuous improvement in all aspects of our perioperative services; with an initial focus on the optimization of the use of “safe surgery” checklists in all of our procedural areas. The Department has instituted an evidence-based best practices model in the area of surgery for colon and rectal surgery to minimize the risk of post-surgical infections, where we have already seen significant advancements.

In addition to participation in NSQIP, the Department is engaged with the Connecticut Surgical Quality Collaborative, a statewide group that encourages and enhances communication between members of best surgical quality improvement practices.

Approach

LifeWings LogoHigh quality care in the Operating Room is dependent upon reliable safety systems and strong communication among the physicians, nurses, technicians and diverse personnel in this area. The operating room team utilizes pre-procedure safety checklists, developed by the World Health Organization, that have been shown to improve surgical outcomes across the world. Team members, surgeons, nurses, anesthesiologists, scrub technicians, and others have trained together using a program called Life Wings, similar to the programs used by airline industry personnel to promote safe aviation. The checklist and the team training combine to promote a culture of safety, empowering staff to note and speak up about any aspect of procedures they feel may impact patient safety.

Results

The Surgery Department tracks numerous measures of the quality of care provided before, during, and after surgical procedures. These measures have been shown to reduce complications after many types of surgery. Examples include the use of medications just before surgery, to control the heart rate, to prevent blood clots and to reduce the risk of infection. Stamford Hospital performs extremely well on these measures which are in line with the national average of 99.1% as noted in Figure 1.

Surgical care

Click Image to Enlarge (Fig. 1)

Stamford Hospital also voluntarily participates in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP®), the first nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care. Among more than 5,000 hospitals in the US, only 766 participate in NSQIP.

NSQIPParticipation in NSQIP allows the Department of Surgery to monitor many aspects of performance and compare its results to those achieved nationwide, including rates of complications (for example, pneumonia and infection), and postoperative mortality rates.

Stamford Hospital performed extremely well in the most recent NSQIP reporting period of calendar year 2014. Stamford Hospital surgeons had mortality rates that were much better than would be expected from national averages, placing us among the best 20% of all participating NSQIP hospitals. (Figure 2).

Mortality Rate

Click Image to Enlarge (Fig. 2)

For more information on the American College of Surgeons NSQIP program, visit their website, at http://site.acsnsqip.org/

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