Florida's participation in quality initiative resulted in statewide improvement

Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®), the Florida Surgical Care Initiative (FSCI) was able to reduce complications by 14.5 percent. The study looks at a 15-month period from March 2011 to July 2012 in which it estimates that the program averted 165 complications, saved an estimated 89 lives, and avoided more than $6.6 million in health care expenses.

"The results of the Florida initiative show that the ACS NSQIP process, applied across a population by committed institutions, can produce dramatic results," said Joseph J. Tepas III, MD, FACS, the lead author of the study: "Macro vs Micro Level Surgical Quality Improvement: A Regional Collaborative Demonstrates the Case for a National NSQIP Initiative."

The research team set out to assess whether FSCI's significantly improved overall results were due to a few outperformers or due to broad-based improvement. The researchers found that most of the 54 participating Florida hospitals improved, and some significantly improved. They also found that the level of improvement for each measure differed from hospital to hospital.

"Almost all hospitals improved, but some improved more than others, and that improvement varied across measures," Dr. Tepas said. "This shows that the global improvement was not the result of a few high performers and that the NSQIP process created a commitment to performance improvement among all of the participants, although with varying degrees of success."

The researchers also argue that the results support the case for the ACS NSQIP collaborative as a systems approach to population-based improvement in surgical care.