The American College of Surgeons National Surgi- cal Quality Improvement Program (ACS NSQIP®) Surgical Risk Calculator was developed in 2013 as a
decision support tool to “provide accurate, patient-specific
risk information to guide both surgeon decision making
and informed consent.” 1-3 Since the introduction of the ACS
NSQIP Surgical Risk Calculator, several studies have been
published validating its use for a range of surgical procedures. 4-7 Little has been published, however, about how this
important tool may also be used for surgical education in
addition to quality improvement in clinical practice.
This article describes our experience with incorporating
the ACS NSQIP Surgical Risk Calculator (see Figure 1, page
30) into weekly morbidity and mortality (M&M) conferences at the department of surgery, New York Presbyterian
Hospital Weill Cornell Medicine, N Y.
What we did
Each week, the chair of quality improvement in our department selects cases for presentation at the M&M conference.
The decision regarding which cases will be presented is
based on several criteria, including perceived educational
value, opportunities to improve patient care, and whether
the cases highlight systems-related or multidisciplinary
issues that may arise in our institution. Beginning in June
2014, all residents were asked to include the ACS NSQIP
Surgical Risk Calculator in each M&M case presentation.
We conducted a retrospective chart review from June 2014
to December 2015 to determine the implementation of the
risk calculator in our M&M conferences.
What we found
We reviewed 124 M&M cases during the 18-month study
period. Of those cases, 13 ( 11 percent) cases did not include
use of the ACS NSQIP Surgical Risk Calculator. A total of
seven of those 13 procedures had Current Procedural Terminology (CPT) codes that could not be accurately captured
Using the ACS NSQIP Surgical Risk Calculator
for surgical education and quality improvement
by Jonathan S. Abelson, MD;
Heather L. Yeo, MD, MHS;
Alfons Pomp, MD, FACS;
David Fehling, MA;
and Fabrizio Michelassi, MD, FACS
DEC 2016 BULLETIN American College of Surgeons