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BC NSQIP SITE
ASSESSMENT
SUMMARY FINDINGS
SURGICAL QUALITY ACTION NETWORK MEETING
FEBRUARY 18TH
2015
AGENDA
1. Poll
2. Introduction
3. Methodology
4. Findings
5. Next Steps
POLL
• Use your phones to respond to questions
• Text to: 37607
• To vote in multiple Choice:
• Enter “number” and
message
POLL
• Use your phones to respond to questions
• Text to: 37607
• To vote in free text:
• Enter “number” then message
INTRODUCTION
NSQIP is currently in place in 25 hospitals in B.C.
The majority of sites have been participating in NSQIP for
nearly 4 years
Consideration is being given to expanding NSQIP to additional
sites across the province
The BCPSQC commissioned an assessment of 5 existing sites
to review their experiences with NSQIP and inform potential
roll out to new sites
METHODOLOGY
Sample of 5 sites interviewed across 4 health authorities
Conducted 18 phone interviews with 19 participants
Roles included:
SCRs
Surgeon Champions
Anesthesia Leads
Quality Improvement Specialists
Administrative Leads
Areas discussed included team structure, data dissemination and characteristics of NSQIP at each site.
Data qualitatively analyzed
Summary Report created
FINDINGS
Implementation
Team
Environment &
Stability
Surgeon
Champion
Engagement
All sites reported
issues during NSQIP
set up:
• Lack of clear roles
& responsibilities
• Staffing mix
• Difficulty
accessing
mentors
• Majority of sites
reported that their
teams worked well
together.
• Turnover of core
team, particularly
SCRs and SC
impacted success
of site
Surgeon Champion
engagement
described as:
• Attending
meetings
• Responding to
emails
• Discussing
NSQIP data with
colleagues
• Engaging in QI
FINDINGS (CONT.)
Clinician
Engagement
Frontline Manager
Support
Leadership
Support
Varying levels of
clinician engagement
at sites. Engagement
affected by:
• Competing
priorities
• Remuneration
• Time
• Skepticism about
data
• Important for QI
and SC to meet
with managers and
present/discuss
data
• Surgical Nursing
Managers key to
accessing frontline
staff for QI
• Positive feedback
about support from
Admin leads
• Financial support
from Senior Exec
• Operational
support from
Senior Exec
lacking at some
sites
FINDINGS (CONT.)
Timeliness of Data
• Majority of sites used
non risk adjusted
NSQIP data for
trending
• Use of other data
sources (Discharge
Abstract Database,
Infection Control
data)
• Introduction of real
time risk adjusted
NSQIP data positive
Must Have Characteristics
for Success
Strong leadership
Engaged and enthusiastic core team to
drive change
Good communication with team and
frontline
Strong QI and data support
Committed and engaged Surgeon
Champion
Sustained commitment from leadership
for QI
Supportive Administrative lead to break
down barriers, and
Remuneration of Surgeon Champions
FINDINGS (CONT.)
Advice for New Sites Starting NSQIP in B.C
1. Board & Senior Executive demonstrates leadership and importance of QI
2. Leverage the current B.C sites for advice (Mentoring)
3. Provide QI training for core team members
4. Tailor data reports to respective audiences (e.g. surgeons, nurses, Senior Exec, Board)
5. Surgeon Champion, QI and SCRs need to understand NSQIP data and how it’s collected before presenting to an audience
6. Have a dedicated QI specialist
7. Recruit a strong Surgeon Champion who has credibility and passion for data and QI
8. Understand that improvement takes time
9. Encourage core team members to attend ACS NSQIP Conference
10. Ensure appropriate space and technology for SCRs
NEXT STEPS
• Review feedback from this session
• Post Summary Report on BCPSQC site
• Review opportunities to publish findings
Any questions or comments about the project
contact Anna Needs [email protected] or
Kimberly McKinley at [email protected]
