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Drive to improve patient outcomes at Nepean goes global

09 Jan 2020


Nepean Hospital is one of only a handful of Australian hospitals using a unique international program to analyse surgical outcomes to help improve the lives of our surgical patients.

The late Associate Professor Patrick Cregan, Professor Michael Cox and Dr Tony Shakeshaft were inspired to bring the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) to Nepean after seeing improvements the program brought to US hospitals.

“Through NSQIP we can track the surgical outcomes of Nepean Hospital’s patients against those from over 750 hospitals in the US, Canada and elsewhere. Complications and other problems become clearly visible in the data helping us to better tackle them,” says Professor Cox.

“We aim to deliver care equal to the best in the world.”

Fellow surgeon at Nepean Hospital, Dr Tony Shakeshaft says NSQIP uses clinical data from medical records, not administrative information which is used by other benchmarking and monitoring programs.

“NSQIP taps into the clinical data of a million patients each year from participating hospitals. Very specific clinical definitions are used so patient outcomes across hospitals and countries can be compared,” says Dr Shakeshaft.

“The data is risk and case-mix adjusted so we can see with great accuracy how our patients’ outcomes compare to thousands of patients who underwent the same procedures.”

Kate Scanlon, a theatre nurse for almost 20 years, is collecting data from over 1,500 Nepean Hospital patients a year for NSQIP. Her experience and knowledge helps her to draw relevant information directly from patients’ clinical records and conduct follow-up phone calls with patients, who are part of the program, 30 days after discharge.

“Working on NSQIP at Nepean means I’m directly involved in quality improvement on a much bigger scale. As a nurse I’m now helping not just one patient at a time but many,” says Ms Scanlon.

“I feel like I’m a making a real contribution to the health of our future patients.”

Operating theatre instruments

The philosophy of NSQIP is particularly attractive to clinicians says Dr Shakeshaft, a colorectal surgeon with over 20 years’ experience in Australia and internationally.

“NSQIP is not a league table of hospitals. The Program specifically stops members from talking publicly about results. It is driven by clinicians to help identify areas to improve and track the effectiveness of quality improvement projects,” says Dr Shakeshaft.

“The focus is very much on better outcomes for patients. There is also a secondary benefit on healthcare budgets with fewer complications and readmissions helping to reduce costs.”

Professor Cox adds NSQIP is an effective way to identify areas where a change in processes can improve outcomes.

Projects based on the Nepean NSQIP data include programs to reduce urinary tract infections, wound infections and post-operative lung complications.

NSQIP, which is used by several surgical teams at Nepean Hospital, is supported by NSW Health’s Agency for Clinical Innovation.

Foundation members of NSQIP in NSW are Nepean Hospital, Westmead Hospital, Port Macquarie Base Hospital and Coffs Harbour Health Campus. The program continues to expand to include more hospitals.