A program with a proven track record of improving the quality of care for surgical patients has been introduced at Mackay Base Hospital and the clinical team overseeing the initiative is excited about its potential.
The National Surgical Quality Improvement Program (NSQIP) was developed by the American College of Surgeons (ACS) in the early 90s to monitor the surgical care of veterans.
The project is led by Surgeon Champion Dr Adrian Westcott and clinical nurse consultant Emma Jacobson, who was appointed to the role of Mackay NSQIP Surgical Clinical Reviewer in July last year.
“This is a program trusted around the world to check and improve on the safety and quality of surgical care and it has now been rolled out in 24 hospitals in Queensland,” Emma said.
“I review surgical patient charts to check the patient recovered well in hospital and speak to them over the phone to assess how they recovered at home after surgery.
“That’s the great thing about NSQIP, I’m not just looking at a chart; but I’m also calling the patient and completing an over-the-phone assessment of how they recovered after surgery so I can really get an accurate portrayal of what’s happened to them post operatively.”
“This is not just about the surgery itself. It’s about making sure that across the entire spectrum of our patient’s journey, we are providing the best care possible.”
Emma has undergone intensive training to use the program and cases are chosen for review via a sophisticated selection process to ensure broad sampling from all surgical specialties.
“I am working towards a goal of reviewing 40 cases every eight days and I am looking to see how the patients are going between 30 and 90 days after their surgery,” she said.
“I’ll be looking at their pre-operative risk factors too which is an important predictor of surgical outcomes. Caring for someone who is elderly or chronically ill is very different to caring for a healthy 18-year-old so we need to consider that in our quality improvements.”
“I also ask some questions about their experience. Questions such as: ‘Did they have the opportunity to discuss the risks with their surgeon prior to surgery? and ‘Did they receive information about their procedure and what to expect afterwards?”
Emma started capturing data for surgeries at the end of September 2024 and is looking forward to the provision of benchmarking reports going forward.
She also said she had a positive response to the process from patients.
“Most people are really excited to either talk about their surgical experience or to know that someone cares how they're going, even after they've maybe been discharged from a post operative clinic list,” Emma said.
“The Post Operative Discharge Support Service (PODSS) was created thanks to NSQIP data from the STARS hospital in Brisbane identifying a need for this kind of service for patients after surgery. The PODSS model of care has now been rolled out across multiple hospitals across the state including Mackay.
“Our patient information brochures are the next quality improvement project we are working on. We want to make them easier to read and more accessible for patients online.”
ACS NSQIP Fast Facts:
- It’s estimated that between 200 and 500 complications are prevented annually in NSQIP hospitals.
- Over 850 hospitals participate in NSQIP around the world.
- MBH is sampling cases from obstetrics, gynaecology, orthopaedics, general surgery (breast, endocrine and colorectal) and urology.
