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 anna.needs@yahoo.com or

Kimberly McKinley at KMcKinley@bcpsqc.ca