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Optimizing Patient Health Before Surgery

Optimizing Patient Health Before Surgery

Throughout the United States, there has been a call to action to improve the quality and safety of surgical care while decreasing costs. In the state of Washington, clinicians have taken a unique approach to surgical quality improvement (QI) with the Strong for Surgery initiative. “Strong for Surgery is a physician-led initiative that identifies and evaluates evidence-based practices to optimize patient health prior to their surgery,” explains Thomas K. Varghese Jr., MD, MS. “We’re working with stakeholders from across the state to raise awareness of key factors in preoperative care that can improve postoperative outcomes.” A Unique Collaborative In 2006, the Surgical Care and Outcomes Assessment Program (SCOAP) was initiated as a peer-to-peer collaborative among hospitals in Washington. SCOAP is a grassroots, voluntary, clinician-led collaborative that includes doctors, statewide insurers, policymakers, and professional organizations of nurses, physicians, nurse anesthetists, and hospitals as well as the Washington state chapter of the American College of Surgeons. Hospitals participate in SCOAP by submitting detailed clinical information about patients undergoing surgical and interventional procedures at their sites. In return, hospitals receive reports that benchmark their performance in care delivery and outcomes. With SCOAP, data are linked from multiple sources (eg, medical records, payers, and surveys) to help participating hospitals assess the longer-term impact of care and complications on patients and the healthcare system. The program includes a set of interventions for standardization—tools like checklists, order sets, and training—to drive performance improvement and clinician education. “SCOAP engages surgeons to determine the processes-of-care metrics that go into an ideal operation,” explains Dr. Varghese. “It tracks risk-adjusted outcomes that are specific to a given operation and...
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