— While surgical outcomes have improved nationally over
time, surgical outcome reporting does not necessarily lead to
better outcomes, according to a Mayo Clinic study published in
the Journal of the American Medical Association.
that capture, analyze, and report surgical outcomes are an
increasingly important part of the quality improvement
movement in health care in the United States. Within the U.S.,
the most widely used surgical outcomes reporting system is the
National Surgical Quality Improvement Program (NSQIP), which
is coordinated through the American College of Surgeons.
study analyzed data regarding surgical outcomes —
complications, serious complications, and mortality — in
over 345,000 patients treated between 2009 and 2013 at
academic hospitals throughout the United States. Of these
patients, approximately half were treated at hospitals that
participated in the NSQIP. The study showed that surgical
outcomes significantly improved overall in both study groups
during the period of analysis.
our study we weren’t interested in whether patients had
better outcomes in NSQIP vs. non-NSQIP hospitals," says
David Etzioni, M.D., chair of Colorectal Surgery at Mayo
Clinic in Arizona and the study author. "We wanted to
know whether the outcomes experienced by patients treated at
NSQIP hospitals improved, over time, in a way that was
different from patients treated at non-NSQIP hospitals."
study found no association between hospital-based
participation in the NSQIP and improvements in postoperative
outcomes over time, suggesting that a
surgical-outcomes-reporting system does not provide a clear
mechanism for quality improvement. According to the research
team, the failure of these types of outcomes monitoring
systems to produce measurable improvements in outcomes may be
related to difficulties in identifying mechanisms that
translate reports into changes in how surgical care is
think if there is one lesson that we have learned at Mayo
Clinic; real quality is achieved through a system — not just
a doctor, not just a nurse or other staff," Etzioni says.
"All of these elements of care have to work together
closely to provide patients with the best possible