By Ms. Suzanne Ovel (Army Medicine)May 12, 2017
JOINT BASE LEWIS-MCCHORD, Wash. -- Madigan Army Medical Center earned high marks for surgical and post-surgical care in a recent report from the National Surgical Quality Improvement Program.
The semi-annual NSQIP report, from the American College of Surgeons, highlighted Madigan's consistently high quality in reducing overall surgical complications and surgical site infections along with other indicators of excellent care. Madigan's Department of Surgery began participating in the voluntary program in 2010.
"It is a way for hospitals to get high-quality, validated data that helps them identify strengths and weaknesses and identify where they could be taking better care of patients," said Lt. Col. Peter Kreishman, Madigan's deputy chief of surgery and a NSQIP surgeon champion for both Madigan and for the Army at large. "The reason this is beneficial is because it allows hospitals to have a real measure of how they stack up against other institutions, both locally and nationally, and it helps identify specific areas where improvement can be done."
Madigan earned 23 exemplary ratings for surgical services by being in the top 10 percent of quality for the more than 800 hospitals who participate in NSQIP. In addition to reduced infections for procedures ranging from colorectal surgery to plastic surgery to ears, nose and throat procedures, Madigan also was noted for its low gynecology complication rates, sepsis rates and urinary tract infections.
Neuro and orthopedic surgeries were especially noted for a lack of UTI complications; in fact, 762 procedures over 12 months resulted in exactly zero UTIs. Kreishman called this achievement "remarkable," as catheters are often used with surgeries, leaving patients at greater risk for this type of infection.
The NSQIP even measures how long patients stay in the hospital as an inpatient; Madigan again ranked in the top 10 percent for their endovascular surgeries of abdominally aortic aneurysms.
"These are patients who get fairly complex aneurysms repaired, and they are usually going home before lunchtime the next day, so we're really proud of that one," Kreishman said.
While NSQIP reports come out every six months, Madigan can pull data from the system whenever needed. Every surgical service chief receives this data and sits with a multidisciplinary team to review both strengths and areas to more finely hone quality.
These improvements in care come about because of a continuous combing over of data from medical chart reviews and phone calls with patients by Madigan's NSQIP surgical clinical reviewer Geri Hough.
Although Hough and Kreishman spearhead the hospital's NSQIP efforts, the key behind the quality improvements are the teams of surgical staff.
"That is 100 percent a testament to the dedication and patient-focus of the staff here at Madigan, because participation in NSQIP alone does not improve your outcomes; you have to use the data and the team here at Madigan from the commander on down are so dedicated to working to improve the outcomes for our patients, and that really shows in these reports," Kreishman said.