ACS Program May Reduce Postsurgical Mortality, Improve Care Among Older Patients

A New Era in Surgical Care: The American College of Surgeons (ACS) Quality Improvement Programs

In a groundbreaking move towards enhancing surgical outcomes, the American College of Surgeons (ACS) has introduced several quality improvement programs aimed at reducing postsurgical mortality and improving care, particularly among older patients. One such program, the ACS Geriatric Surgery Verification program, has shown promising results in improving patient safety and outcomes.

The Need for Improved Surgical Care

Postoperative mortality remains a significant concern worldwide. According to recent statistics, postoperative mortality accounts for roughly 1% of deaths, translating to about 4 million deaths annually. This stark reality underscores the need for robust quality improvement initiatives in surgical care.

The ACS National Surgical Quality Improvement Program (ACS NSQIP)

The ACS NSQIP is a variable-based data registry designed to improve hospital-wide quality across all surgical departments. By collecting data directly from patient records, this program provides hospitals and staff with the most accurate and risk-adjusted information to inform patient outcomes. Since its inception, ACS NSQIP has been instrumental in reducing morbidity and mortality by facilitating informed decision-making and systematic improvement in surgical care.

Key Benefits of ACS NSQIP

• Enhanced Data Accuracy: Unlike claims data, ACS NSQIP provides a more reliable method of measuring quality, identifying 61% more complications, including 97% more surgical site infections.
• Risk Adjustment: The program accounts for the complexity of operations, allowing hospitals to calibrate their results based on the type of procedures they perform.
• Extended Tracking: ACS NSQIP tracks patients for 30 days post-surgery, providing a comprehensive view of their care and reducing costly readmission rates.

The ACS Quality Verification Program

The ACS Quality Verification Program (ACS QVP) is another significant initiative aimed at establishing, measuring, and improving hospital-wide quality infrastructure. This evidence-based program focuses on standardized team-based and disease-based clinical processes to enhance surgical care.

Key Components of ACS QVP

• Standardized Processes: ACS QVP emphasizes the importance of standardization across all five phases of care: preoperative, immediate preoperative, intraoperative, postoperative, and post-discharge.
• Customized Reports: Hospitals participating in the program receive customized reports with actionable recommendations tailored to their specific needs, enhancing leadership, safety culture, and standardization.
• Verification Levels: The program offers two levels of verification—ACS QVP Focused and ACS QVP Comprehensive—allowing hospitals to choose the level that best suits their current infrastructure and goals.

Implementing the ACS Geriatric Surgery Verification Program

The ACS Geriatric Surgery Verification program is specifically designed to improve the care and outcomes of older surgical patients. By verifying compliance with evidence-based standards, this program aims to reduce postsurgical mortality and improve overall care among older patients.

Key Benefits of the Geriatric Surgery Verification Program

• Improved Patient Safety: The program ensures that hospitals adhere to standardized protocols specifically tailored for geriatric patients, reducing the risk of complications and improving patient safety.
• Enhanced Care Coordination: By emphasizing multidisciplinary management, the program ensures better coordination between various healthcare teams, resulting in more comprehensive care for older patients.
• Reduced Complications: The program’s focus on preventing complications specific to geriatric patients, such as uncontrolled bleeding and cardiovascular issues, significantly reduces the risk of postsurgical mortality.

Real-World Examples

Several studies have highlighted the effectiveness of the ACS NSQIP and other quality improvement programs in reducing morbidity and mortality. For instance, a study comparing surgical outcomes between hospitals participating in the NSQIP and those that did not found no significant differences in complication rates or mortality.

Conclusion

The ACS’s quality improvement programs represent a major leap forward in enhancing surgical care and reducing postsurgical mortality. By leveraging robust data collection, standardized processes, and evidence-based protocols, these programs are poised to make a significant impact on patient outcomes, particularly among older patients.

While these initiatives are promising, continuous monitoring and improvement are crucial. As healthcare continues to evolve, it is essential that these programs remain at the forefront of quality improvement, ensuring that every patient receives the highest standard of care available.

References

• ACS National Surgical Quality Improvement Program
• New Research Supports ACS Quality Verification Program Standards
• Postoperative Mortality – And How to Prevent It