Vha’s NSQIP Program, Essay Example

The National Veterans Association Surgical Quality Improvement Program (NSQIP) was utilized as an empirical resource for surgeons throughout the VMA and the 123 VAMCs practicing surgery to communicate with one another through a centralized resource of information.  Together, professionals were able to submit information through a computer information system that was not only high active and informative, but it was also supported by the upper level executive management.  This was critical because it not only showed the alarming need for such massive intercommunications for improved surgical techniques, processes and results; it also promoted the use of the NSQIP through strong support by the top executives within the VMA and VAMCs.  Without this component, the successes of this program to improve surgical efficiency and knowledge throughout the 123 VAMCs would not have been as high.  Essentially, without the backing of the executive managers, the lower level physicians and surgeons would not have taken this program as seriously and used it to improve the entire surgical operations program within the organization.

The approach for the NSQIP program was one in which all surgeons would work together to communicate errors, successes and areas of improvement from each surgery they performed.  Risk adjusted, outcomes data was highly sought after in order to reduce overall inefficiencies and the senior surgeons quickly realized the importance of such a program.  The goal was to enable quality management of the VA surgical and medical centers in order to “provide reliable, valid and comparative information” surrounding the various surgical outcomes that were being experienced.  The belief of the VMA is that the quality of recovery and lifestyle of the patient is directly related to the quality of care that the patient received from the surgeons.  In order to improve this quality of life, it is important to consider the multiple health and risk factors associated with each case to learn and improve upon the overall quality of care.

The research was focused on including multiple benchmarks for successful analysis and improvement of surgical processes and techniques.  For instance, the postoperative morbidity was tracked through the NSQIP and compared against the 20 postoperative complications that had been pre-defined by the senior surgeons.  Furthermore, the research included data on patient risk factors, intraoperative process information, and length of stay in addition to the postoperative mortality and morbidity rates.  These rates were compared to the observed-to-expected ratios predetermined by the senior surgeons and were utilized as the benchmarks for determining quality of care.  Through the use of the NSQIP and the data found within the program, several improvements were shown in each of the mortality, morbidity and length of stay variables.  These improvements were attributed by the NVASRS and NSQIP to improved surgical and anesthetic techniques, supervision of residents in surgical training and the marked improvements in technology and equipment in each of the 123 participating VAMCs.  Essentially, these improvements were implemented as a direct result of the data analyses and results-oriented information found within the NSQIP.  This clearly shows that the goals of the senior surgeons were realized within the NSQIP to improve the quality of surgical and communicative techniques and processes used.

An important component to the NSQIP research was the differences in quality of communication found in better-than-expected and less-than-expected outcome levels VAMCs.  The ongoing research and practice techniques were only communicated through the NSQIP centralized computer system for all 123 VAMCs to be inter-linked, but senior surgeons involved in the program also made regular visits to track each VAMC and analyze its communication and medical treatment methods.  These are several of the control methods found within the program that were used to point out areas of strength and areas of improvement while maintaining the focus on improving the overall quality of care for the patient.  A major component to the success of the NSQIP is the unique VISTA centralized computer system that allowed information from each of the 123 VAMCs to be centrally-stored and readily available at any location.  This VISTA system was produced by the VMA and has been utilized elsewhere throughout the country to improve communicative, data sharing and data analyses tasks within the medical community.