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HAI at FHA: NSQIP Data Tells the Story November 2010

HAI at FHA: NSQIP Data Tells the Story November 2010. NSQIP at FHA Rates – SSI, UTI and Sepsis O/E – SSI and UTI Process + Outcomes Measure How NSQIP can help your team Future of NSQIP at FHA. NSQIP. *National Surgical Quality Improvement Program

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HAI at FHA: NSQIP Data Tells the Story November 2010

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  1. HAI at FHA:NSQIP Data Tells the StoryNovember 2010

  2. NSQIP at FHA • Rates – SSI, UTI and Sepsis • O/E – SSI and UTI • Process + Outcomes Measure • How NSQIP can help your team • Future of NSQIP at FHA

  3. NSQIP *National Surgical Quality Improvement Program *Data-driven, risk-adjusted, outcomes-based surgical quality improvement program -systematic sampling process -30-day outcome -robust data collection -data validity -report flexibility

  4. NSQIP at FHA 2006 Royal Columbian Hospital Surgeon Champion: Dr. Peter Blair SCR: Betty Allan Surrey Memorial Hospital Surgeon Champion: Dr. Peter Doris SCR: Angela Tecson 2009 Burnaby Hospital Surgeon Champion: Dr. JeanNoel Mahy SCR: Darlene Jager NSQIP Director: Lorraine Gillespie FHQC- Fraser Health Quality Collaborative Can-NSQIP – Canadian NSQIP Collaborative

  5. HAI Rates Surgical Site Infection

  6. HAI Rates Urinary Tract Infection

  7. HAI Rates Pneumonia

  8. HAI Rates Sepsis/Septic Shock

  9. O/E Ratio • Observed to Expected Ratio “O” = number of observed events “E” = number of expected events on the basis of risks and complexity • Risk Adjustment – “levels the playing field” • Outlier – statistically “better” or statistically “worse” than expected

  10. Overall Surgical Site InfectionsRCH and SMH – GS and VSBH – Multispecialty (Initial Year) 2007 2009 SMH RCH SMH RCH BH SMH Reduction Rate: 49% RCH Reduction Rate: 29%

  11. Overall Urinary Tract InfectionsRCH and SMH – GS and VSBH – Multispecialty (Initial Year) 2007 2009 SMH RCH RCH SMH SMH BH SMH Reduction Rate: 54% RCH Reduction Rate: 24%

  12. NSQIP Data at FHA • 30-day outcomes collected – phone calls, letters and surgeons office visits • Preoperative data is limited to chart and EMR information • No risk-adjusted report on postoperative sepsis/septic shock • O/E reports – twice a year

  13. Process and Outcomes Measure • Are we really doing what we said we are doing? • Is what we are doing creating an impact? Example: Dec 2009-Jan 2010 176 Cases General and Vascular Surgery

  14. Process and Outcomes Measure Example: SSI Infection Reduction Strategies Preop Antibiotic Compliance – 87.5% P-value: .001 Odds Ratio: 6.1 P-value: .00008 Odds Ratio: 7.2

  15. How can NSQIP help? Data Definition Support– SSI, UTI and Sepsis Reports: • Monthly rates • Benchmark • Risk-adjusted data – Semiannual Report • SPC Charts – specific cause variation

  16. NSQIP’s SPC Chart Example

  17. Future of NSQIP at FHA • Multispecialty Targeted Procedure Module • Risk calculators – pre-admission • Partnership with UBC statisticians • Partnership with BCPSQC • Increase site enrollment • Continue to share evidence-based practices

  18. Thank you! Email: .FHA surgical clinical reviewer Website: www.acsnsqip.org

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