Walter Reed Bethesda’s Directorate of Surgery Recognized for Quality Care

UNITED STATES

12.04.2020

Story by Bernard Little 

Walter Reed National Military Medical Center

For the second consecutive year, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) recognized Walter Reed National Military Medical Center (WRNMMC) for earning meritorious outcomes for surgical patient care.
WRNMMC was one of 89 ACS NSQIP achieving the recognition for the period covering Jan. 1 to Dec. 31, 2019. As a participant in ACS NSQIP, WRNMMC is required to track the outcomes of inpatient and outpatient surgical procedures and collect data that assesses patient safety and can be used to direct improvement in the quality of surgical care.
The ACS NSQIP recognition program commends a select group of hospitals for achieving a meritorious composite score in either an “All Cases” category or a category which includes only “High Risk” cases. Risk-adjusted data from the July 2020 ACS NSQIP Semiannual Report, which presents data from the 2019 calendar year, were used to determine which hospitals demonstrated meritorious outcomes. WRNMMC has been recognized on the “All Cases” Meritorious list for the second year in a row.
“It means we are demonstrating a sustained pattern of quality, safety and excellence,” stated Army Col. (Dr.) Benjamin Potter, director for surgery at WRNMMC, professor of surgery and rehabilitation at the Uniformed Services University, and orthopaedic surgery consultant for the U.S. Army surgeon general.
“Our directorate’s, and the hospital’s efforts at providing quality care and continuous improvement are effective where it matters most – patient outcomes,” Potter added. “The entire directorate – from surgeons to anesthesia to nurses and techs and our clinic staff who provide pre-operative and post-operative care -- contributed to this achievement.”
Hospitals participating in the ACS NSQIP, like WRNMMC, are committed to continuously monitoring and improving surgical outcomes, WRNMMC Director Army Col. (Dr.) Andrew Barr agreed. He also credited surgeons, physicians, nursing staff and administrators for the achievement. “They are all part of our one team [with] a constant focus in one of the most critical aspects of medicine [surgery] and keeping our patients safe, reviewing our cases and making sure we are doing the right thing at all times. [This award] is just an excellent representation of that [focus].”
The ACS NSQIP is a nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care, according to ACS officials. “Built by surgeons for surgeons, ACS NSQIP provides participating hospitals with tools, analyses, and reports to make informed decisions about improving quality of care. Further, peer-reviewed studies have shown that ACS NSQIP is effective in improving the quality of surgical care while also reducing complications and costs,” they add.
Each hospital’s composite score was determined through a different weighted formula combining eight patient management outcomes in clinical areas: mortality; cardiac arrest and myocardial infarction; respiratory illness such as pneumonia; unplanned intubation; ventilator care for more than 48 hours; renal failure; surgical site infection (SSI- superficial and deep incisional and organ-space SSI; and urinary tract infection (UTI).
The 89 commended hospitals achieved recognition based on their composite quality score across the eight areas. Seventy-two hospitals were initially recognized on the “All Cases” list and 72 hospitals were initially recognized on the “High Risk” list; the 72 hospitals represent 10 percent of the 719 calendar-year 2019 ACS NSQIP hospitals. Fifty hospitals are recognized on both the “All Cases” and “High Risk” lists, 20 other hospitals are on just the “All Cases” list, and 19 other hospitals are on the “High Risk” list only – yielding 89 hospitals in total.
Other military treatment facilities recognized were:
• Brooke Army Medical Center at Joint Base San Antonio-Ft. Sam Houston, Texas
• Dwight D. Eisenhower Army Medical Center at Fort Gordon, Georgia
• Carl R. Darnall Army Medical Center at Fort Hood, Texas
• Naval Hospital Jacksonville at Naval Air Station Jacksonville, Florida
• David Grant U.S. Air Force Medical Center at Travis Air Force Base, California
• Womack Army Medical Center at Ft. Bragg, North Carolina
Air Force Col. (Dr.) Peter Learn serves as deputy director of surgery for quality at WRNMMC, associate chair of surgery for quality and patient outcome and co-chair on the DoD NSQIP steering panel. He stated a certain level of transparency comes from DoD MTFs comparing themselves to civilian facilities.
“NSQIP helps reassure our patient population that we take the quality of care that we’re delivering them very seriously, to the point that we are willing to benchmark ourselves against non-military institutions,” Learn said. “NSQIP is a voluntary program, so we’re already comparing ourselves against group of hospitals that are willing to subject themselves to that scrutiny.”
“I think that if we can assure ourselves that we are delivering high-quality care stateside, then it better prepares us to deliver high-quality care in the deployed environment as well,” Learn furthered.
“ACS NSQIP is the only nationally validated quality improvement program that measures and enhances the care of surgical patients. This program measures the actual surgical results 30 days postoperatively as well as risk adjusts patient characteristics to compensate for differences among patient populations and acuity levels,” according to ACS officials.
The goal of ACS NSQIP is to reduce surgical morbidity (infection or illness related to a surgical procedure) and surgical mortality (death related to a surgical procedure) and to provide a foundation for surgeons to apply what is known as the “best scientific evidence” to the practice of surgery. In addition, when adverse effects from surgical procedures are reduced and/or eliminated, a reduction in health-care costs follows, state ACS officials. “ACS NSQIP is a major program of the American College of Surgeons and is currently used in nearly 850 adult and pediatric hospitals,” they add.
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. ACS officials state, “The college is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The college has more than 82,000 members and it is the largest organization of surgeons in the world.”

• Date Taken: 12.04.2020
• Date Posted: 12.04.2020 10:39
• Story ID: 384210
• Location: US