According to the AHRQ www.ahrq.gov Issue Brief, “Harnessing the Power of Data” published August 2015, the AHRQ-supported “Surgical Care and Outcomes Assessment Program” (SCOAP) has helped the majority of hospitals in Washington State. SCOAP was started by David Flum, M.D at the University of Washington, School of Medicine www.uwmedicine.org. As he reports, “Clinicians are seeking data that can help them take better care of patients in the next week based on the care they delivered in the last week. What we are trying to do is harness the data, find the patterns and trends in yesterday’s care, and turn that data into usable information”.
Hospitals participating in SCOAP collect and share details on what surgeons are doing in operating rooms and how patients fare afterwards. Data from 38 of 62 Washington State hospitals providing surgical care are included in SCOAP’s Surgical Outcomes Registry.
The registry data enables clinicians to examine patient outcomes and learn how the hospital compares to others and to national standards. The data also helps identify areas that need improvement.
Dr. Flum and his team began to see patterns of care around pre-surgical patient characteristics as well as operating room behaviors that strongly influenced surgical outcomes. This led to the development of an in-hospital surgical checklist-based program that improved surgical care and reduced costs.
The in-hospital surgical checklist is a key part of SCOAP’s surgical improvement efforts. Prior to surgery, the team confirms the surgical site, exact procedure, and any anticipated difficulties or blood loss.
The team also confirms that antibiotics were given at the right time, determined whether the patient was diabetic, determined the medications that the patient is taking, and/or if there are or were any allergy issues. After surgery, the checklist ensures that no sponges or other objects are left inside the patient and that the patient continues to take the important medications they were taking prior to surgery.
Following the success of the in-hospital surgical checklist, the focus shifted to the pre-surgical clinic setting. This led to the launch of a public health campaign called “Strong Surgery” promoting the use of pre-surgical intervention to optimize patient health before surgery and to improve outcomes after surgery.
The development of surgical checklists and the continued analysis of clinical data about procedures and outcomes among Washington State hospitals has resulted in reduced complication rates, produced shorter hospital stays, and resulted in fewer 30 day re-hospitalizations.
AHRQ awarded a grant to develop the “Comparative Effectiveness Research Translation Network (CERTAIN)” to address questions across a wide range of clinical areas. Together SCOAP and CERTAIN are developing a learning healthcare system that is driving process improvement and reducing variations in care, adverse outcomes, and healthcare costs. CERTAIN links hospital outcomes data with patient-reported information to create a patient-centered, disease-based research network.
Go to www.ahrq.gov/research/findings/factsheets/informatic/databrief/index.html to view the AHRQ Issue brief. For more information email Arlene Bierman, M.D. at Arlene.bierman@ahrq.hhs.gov.