ACS Bulletin - February 2017

by Tony Peregrin

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The 2016 Trauma Quality Improvement Program (TQIP)

Annual Scientific Meeting and Training, November 5− 7 at the Omni Orlando Resort at ChampionsGate, FL, drew nearly 1,600 attendees—the highest number to date— including trauma medical directors, program managers, coordinators, and registrars.

“There are so many people
here today—all of whom are
committed to the care of the
patient,” said Avery Nathens, MD,
PhD, FACS, FRCSC, in his opening
remarks at the seventh annual
meeting. Dr. Nathens is surgeon-
in-chief, department of surgery,
and medical director, trauma,
Sunnybrook Health Sciences
Centre, Toronto, ON, and Medical
Director of the American College
of Surgeons (ACS) Trauma
Quality Programs. “We aspire
to zero preventable deaths,” he
said. “I think, with the degree
of commitment in this room,
that is possible,” referring to the
seminal report released by the
National Academies of Sciences,
Engineering, and Medicine
(NASEM) Committee on Military
Trauma Care’s Learning Health
System and Its Translation to
the Civilian Sector’s A National
Trauma Care System: Integrating
Military and Civilian Trauma
Systems to Achieve Zero Preventable
Deaths after Injury, cosponsored
by the ACS. The report calls
for eliminating all preventable
deaths in both military and
civilian trauma patients.

Topics covered at the 2016

TQIP meeting include best practice guidelines for palliative care, an overview of the ACS TQIP Collaboratives program, lessons learned from the Pulse nightclub mass casualty event, and a presentation from trauma survivor-turned-Ironman triathlete Brian Boyle.

TQIP update

Dr. Nathens provided an update on key TQIP initiatives including a new program, Level III TQIP, which launched in July 2016 and extends the program to more levels of care.

The program includes access to risk-adjusted benchmarking, opportunities to share best practices, and online education customized to Level III centers.

Dr. Nathens also highlighted the ACS Registries Project, which will migrate all ACS clinical registries into a single platform.

“We worked to find a partner to meet the needs of all of the ACS Quality Programs,” he said. “You will see a lot of integration of data across all programs.

[However,] I want to make an
important clarification—local
registries will remain the same.

What you will see differently
are business intelligence
tools that will help you better
understand the data. And from
a reimbursement standpoint,
you will be able to export data to
the Surgeon Specific Registry.”
Dr. Nathens also spoke
about the TQIP Collaboratives,
through which hospitals in either
a specified geographic area or a
hospital system work together
with a shared goal of trauma
system quality improvement.

At present, Florida, Georgia, Michigan, Pennsylvania, and Texas have TQIP Collaboratives, and North Carolina, parts of California, and the Committee on Trauma (COT) Region III are in the process of forming TQIP Collaboratives.

Another TQIP initiative of note centers on best practice guidelines for managing different patient populations and processes. Past TQIP Best Practice guidelines have included standards for the management of geriatric trauma patients, massive transfusion, traumatic brain injury, and orthopaedic trauma. A new best practices guideline for palliative care will be released in 2017. The next TQIP guideline will focus on imaging in pediatric trauma.