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BC NSQIP SITE ASSESSMENTSUMMARY 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
ImplementationTeam
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]