Andrea L. Lubitz MD, MPH; Elaine Chan, MD, FACS; Daniel Zarif, MD; et al found that the American
College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) Surgical Risk
Calculator is valuable in aiding in shared decision making between patients and surgeons and predicts
outcomes accurately in elective colorectal cases. However, it underestimates serious complications
and length of stay and overestimates discharge to skilled nursing facilities in emergent cases.
This article and all other Journal of the American College of Surgeons (JACS) content is available
at www.journalacs.org. ♦
Examining ACS NSQIP Surgical Risk Calculator accuracy
for emergent and elective colorectal operations
Making quality stick:
Optimal Resources for Quality and Safety
Editor’s note: In July, the American College of Surgeons (ACS) released Optimal
Resources for Surgical Quality and Safety—a new manual that is intended to
serve as a trusted resource for surgical leaders seeking to improve patient
care in their institutions and make quality stick. Each month, the Bulletin
will highlight some of the salient points made throughout the manual.
In recent years, the public demand for quality medical care has heightened. The ACS has been well-positioned to play a leading role in this movement given its more than 100 years of experience in
quality improvement and in applying what Ernest Amory Codman, MD, FACS, described as the end
result idea. Optimal Resources for Surgical Quality and Safety is grounded in the same philosophy that
has inspired quality for generations of surgeons: set the standards, build the right infrastructure,
use the right data, and verify that appropriate care is provided through external review.
Health care policymakers and professionals who have studied quality, safety, and reliability
also have increasingly found that the best way to reduce complications and variations in patient
care is through a coordinated, physician-led, team-based approach. And while the individual
surgeon may no longer make autonomous decisions, he or she remains at the center of the team
and ultimately is responsible for the patient’s safety across the continuum of care, starting with
the preoperative evaluation and obtaining informed consent and ending postdischarge.
The five phases of surgical care and the surgeon’s responsibilities in each are described
in detail in Optimal Resources for Surgical Quality and Safety. The notion that it is the
surgeon—working in concert with other professionals on the patient-care team, the
patient, and the patient’s family—who must take steps to ensure a positive end result is
timeless, and it is the message that resonates consistently throughout this manual.
Be sure to read next month’s overview of Optimal Resources for Surgical Quality and Safety,
which will focus on the role of the Surgical Quality Officer and case review and peer review.
Optimal Resources for Surgical Quality and Safety is available for $44.95 per copy for orders of nine copies
or fewer and $39.95 for orders of 10 or more copies at web4.facs.org/eBusiness/ProductCatalog/product.
aspx?ID=853. The manual also can be purchased on Amazon.com for $44.95 plus shipping and handling. ♦