Redesigning a More Actionable, Service Line Specific, Surgical Performance Dashboard for an Academic Referral Hospital by Adding Severity of Post-Operative Complications

From these initiatives, the Agency for Healthcare Research and Quality, National Quality Form, and other professional groups such as The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) were born. 1 NSQIP is a registry that provides a “data driven, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care. 2 ” This voluntary database currently includes over 800 U.S.-based hospitals. 2 This benchmarking allows for standardized comparisons between different organizations. 2 In theory, by identifying high performing organizations, best practices can be recognized and disseminated to improve overall outcomes at an organizational and national level. 3 Utilizing reports from NSQIP, hospitals can undertake quality improvement (QI) projects in areas of underperformance.2,4 Traditionally, when focusing on QI, a variation analysis is used amongst institutions, which can lead to top quartile institutions becoming complacent despite having opportunities to improve surgical outcomes. [...]these weaknesses can result in surgeons lacking an optimized dashboard that promotes action and allows them to institute change based on the severity or sequela of complications to improve care delivered. In surgical literature, a well-validated and universally applied schema for rating complications is lacking. 8 Thus, it becomes difficult to understand the impact of various complications, visualize trends, compare different institutions, and even evaluate different publications. [...]a more comprehensive dashboard should integrate severity and complication sequela and then be organized by service line to allow providers to optimally address quality. [...]a novel dashboard was constructed that combines NSQIP outcomes data with severity for providers to assess quality and improve delivery of care.