NSPSS workgroup 3: TECHNOLOGY
GOALS: identified principles, measures, and programs needed for collection and analysis of surgical safety data to drive performance measurement.
PROPOSAL: Presently, the American College of Surgeons and the American Society of Anesthesiologists have created separate data registries (ACS NSQIP, NACOR) for measuring and reporting surgical outcomes for patients undergoing non-cardiac surgery. Other surgical subspecialties are in the process of building separate outcome registries. Each of these registries is a stand-alone database. We propose to create a virtual data warehouse linking NSQIP, NACOR, and surgical subspecialty data registries. NSQIP and NACOR would comprise the core of the new registry. NACOR would augment NSQIP with information on intraoperative management – data on hemodynamics, fluid and blood replacement, drug administration, intraoperative outcomes, and staffing. Each of the subspecialty registries would include specialty-specific outcomes (e.g. functional outcomes in orthopedics) and specialty-specific risk factors.
Panel: Kevin Bozic, MD, MBA; David Jevsevar, MD, MBA; David ring, MD, PhD; Clifford Ko, MD, Janice Kelly, MS, RN-BC; Laurent gloss, MD
.We have learned that the debriefing process is critical - we use data to augment this process by assessing the care of 1000 s of patients.
.We have the data infrastructure in place and recognize that the data is the backbone of an HRO.
.Our ultimate goal should be data sharing but we are challenged by linking these data sets for various reasons. One route would be to give everyone a lifetime patient identifier.
.We are being asked to move from volume based care to value based care and we should be in control of that. To do this we must evaluate teams and not surgeons evaluating surgeons. We need performance measures that evaluate how we do together. We need surgeons, anesthesiologists and nurses to get together to develop this model.
.It will be up to us to go to the EMR vendors to explain that our data needs to be incorporated into the EMR and we must clarify definitions that are consistent. Several expressed that currently vendors may not be as adaptable as we would like.
David Hoyt stated that the College is interested in measurement fields that those in practice desire collecting and measuring so they can modify the database to include this.