6 strategies for quality and patient safety improvement from the American College of Surgeons

The American College of Surgeons provides guidelines to help surgeons improve quality and patient safety in its 2017 manual, Optimal Resources for Surgical Quality and Safety. Here are six strategies the ACS recommends, with details according to McKesson.

1. Adopt a patient-centered, physician-led and team-based surgical care model.

Coordinating resources and expertise during all five phases of surgical care improves the quality and safety of a procedure. The five phases are preoperative evaluation and preparation; immediate preoperative readiness; intraoperative; postoperative; and post-discharge.

2. Create the position of surgical quality officer.

The surgical quality officer should be responsible for managing the infrastructure, internal systems, clinical protocols and practice standards that promote quality care. This individual would also ensure the surgical care team has access to the tools, resources and training necessary to support optimal care.

3. Make surgical case review and peer review opportunities for quality improvement.

The ACS recommends conducting all five types of reviews: single-discipline case review, multidisciplinary case review, peer review of individual surgeons, data/registry review and educational review conference. ASCs should implement solutions to address any problems discovered and continuously measure performance.

4. Strengthen the internal surgical quality and safety committee.

Provide the committee with adequate resources to oversee surgical mortality and adverse event rates, resolve surgical practice variations, establish quality and safety policies, identify surgical issues and develop corrective action plans.

5. Build a surgical culture focused on quality, safety and high reliability.

Consider eliminating common barriers to a culture of patient safety, such as long-established hierarchies, departments that operate in silos and accepted deviances from standardized practices. Apply the defining characteristics of a high reliability organization: preoccupation with failure, sensitivity to operations, reluctance to simplify interpretations, commitment to resilience and deference to expertise.

6. Expertly use data to monitor and drive quality and safety improvements.

Collecting, analyzing, reporting and acting on data is key to implementing improvement strategies. ASCs should consult regional and national surgical databases and benchmark performance.

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