The Illinois chapters of the American College of Surgeons (ACS), Blue Cross and Blue Shield of Illinois (BCBSIL), and Northwestern Medicine- have come together to offer selected hospitals across Illinois the opportunity to join the Illinois Surgical Quality Improvement Collaborative (ISQIC), a three-year effort to improve the safety and quality of surgical care in Illinois. Funded by BCBSIL, the Collaborative will use the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP-) to analyze the surgical practices and outcomes of participating hospitals, and identify specific improvements to reduce surgical complications, the length of inpatient stays, readmission rates and deaths.
"We're making an investment in the future of health care quality for Illinois by partnering with Northwestern Medicine and the American College of Surgeons," said Carol Wilhoit, MD, MS, senior medical director of quality and outcomes for BCBSIL. "This collaborative brings hospitals and quality improvement experts together as a team with the singular goal of improving surgical care for patients."
Each hospital will receive customized performance reports; areas of poor performance then become the focal point of improvement efforts for that hospital. In addition, Northwestern Medicine's Surgical Outcomes and Quality Improvement Center will lead the ISQIC Coordinating Center to provide quality improvement training and support, develop Illinois-specific performance results and perform research around the initiative.
"Research shows that when hospitals partner with each other to examine the safety and quality of care using high quality, detailed comparative data, they can learn from each other and improve far more than any one hospital working in isolation," said Karl Y. Bilimoria, MD, MS, surgical oncologist at Northwestern Memorial Hospital and director of the Surgical Outcomes and Quality Improvement Center at Northwestern University Feinberg School of Medicine. He added, "The goal of the Collaborative is to use detailed surgical performance data to identify opportunities for improvement and have hospitals work together through sharing their experiences and practices, in order to develop effective and self-sustaining improvements that truly benefit patient care."
"This Collaborative is a landmark surgical quality partnership for participating Illinois hospitals. Quality improvement programs typically succeed because surgeons and other clinicians willingly participate in the effort. And while we have seen demonstrable improvement in care and outcomes in hospitals who work individually, we have also seen valuable gains when hospitals participate in a collaborative," said Clifford Y. Ko, MD, FACS, director of the ACS Division of Optimal Research and Care, which administers ACS NSQIP. "One of the real powers of a Collaborative comes with sharing the right type of health care data to improve patient care. ACS NSQIP uses risk-adjusted data that enables surgeons and hospitals to compare their outcomes with other participating surgeons and hospitals to help them understand where they're performing well, and where they need to improve. Given the stakeholders and participants in this current Collaborative, we are confident great accomplishments and advances will be seen."
By improving the surgical outcomes of patients, research also indicates that substantial healthcare savings can be achieved as a result. According to a study in the October 2004 issue of the Journal of the American College of Surgeons, preventing even minor surgical complications like a superficial wound infection can save $10,000 to $30,000 in additional costs per patient. Preventing more complex infections reportedly save up to $100,000. These and other findings show that a hospital can lower medical costs by at least $1 million a year by reducing the rate of surgical infections.
Similar surgical collaboratives have been setup with support from BCBS in other U.S. states, all of which have experienced a dramatic reduction in surgical complications and healthcare costs. The ISQIC program however, is the first to utilize several new improvement strategies to better engage hospitals and create an even greater reduction of surgical complications.
"Other states have tried to do something similar," said Bilimoria, who is also a faculty scholar at the American College of Surgeons and the coordinator of the ISQIC initiative. "But this collaborative will be the first to provide hospitals with intensive quality and process improvement mentoring, training and coaching, as well as several other unique approaches."
The Illinois Collaborative is also the first to provide all participating hospitals with the opportunity to apply for pilot grants to help them implement solutions to issues identified using their ISQIC performance reports. Unlike the other collaboratives, all of the participating hospitals will undertake annual quality improvement projects together as part of the three-year ISQIC program. The ISQIC program begins recruiting Illinois hospitals in December 2013. If successful, ISQIC's program would become a model for expansion to additional Illinois hospitals.
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