The American College of Surgeons issued a national call for interested hospitals to join a new cohort of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR). Presented in collaboration with the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, the ISCR program enables hospitals to implement enhanced recovery pathways, which have been shown to improve safety, decrease complications, shorten recovery times, and reduce length of stay for surgical patients. The program is funded and guided by AHRQ.
The next group of enrollees, who will participate in Cohort 3B, can begin participation on September 1, 2019. Due to strong interest in the previous cohort, the advanced enrollment period for hospitals has been lengthened, and is now open. Once enrolled, participating hospitals will have access to tools for implementing enhanced recovery pathways for colorectal, gynecology, total joint replacement and hip fracture pathways.
The AHRQ ISCR program seeks to improve surgical patient outcomes by increasing the implementation of enhanced recovery practices in participating hospitals through the use of an adaption of AHRQ’s Comprehensive Unit-based Safety Program (CUSP), a model for sustainable safety improvement that has been associated with preventing harm in multiple areas. There is no cost to participate in the program.
“This program provides protocols and strategies for hospitals to improve their surgical outcomes. Even if they are already using some enhanced recovery protocols, we have identified specific opportunities that help hospitals become even better. We invite all interested hospitals to enroll so they have full access to the program’s resources, support and clinical experts,” said Clifford Y. Ko, MD, MHS, FACS, director of the ACS Division of Research and Optimal Patient Care.
Since the start of the first cohort in July 2017, the AHRQ ISCR program has actively supported participants in implementing evidence-based surgical care. The initial cohort focused on colorectal operations. The second cohort, launched in March 2018, expanded the program’s work to include total joint replacement and hip fracture operations. A third cohort, started in March 2019, provided a new area of focus for gynecologic procedures.
This comprehensive program allows participating hospitals to work to improve surgical patient outcomes, reduce length of stay, prevent complications, increase reliability and standardization of care, improve efficiency, and improve surgical teamwork and the hospital’s surgical care culture.
“It’s key to the American College of Surgeons’ mission to bring forth to the nation this proven quality approach for improving surgical care and recovery,” David B. Hoyt, MD, FACS, ACS executive director. “Not only does this program provide a steady path forward for hospitals to easily participate, we’re now expanding the number of surgical procedures for surgical teams to focus on.”
Participating hospitals receive a ready-to-use pathway, access to education materials on how to implement the pathway, access to experts in performance improvement and education who will help them troubleshoot as they implement, and inclusion in a community of surgeons and perioperative teams rolling out the same pathway.
Enrolled hospitals also have the opportunity to join monthly coaching calls and national leader webinars to learn from their colleagues and other experts in the field. Coaching calls are discussion driven on topics such as patient and staff education, specific clinical practice area changes such as bowel preparation or multimodal analgesia, and barriers to and facilitators of implementation, including such issues as coordinating multidisciplinary teams, communicating and working across units, surgeon engagement, or the electronic health record. National leader webinars are clinically focused. Topics have included bowel prep versus oral antibiotics, preoperative lab testing, venous thromboembolism prophylaxis, building a culture of mobility, and delirium screening.
“This program can have a remarkable impact on improving surgical care across the U.S. Fewer complications, shorter hospital stays, lower costs. It’s all possible when surgical patient care is delivered within an enhanced recovery framework,” said Elizabeth Wick, MD, FACS, who is affiliated with Johns Hopkins Medicine Armstrong Institute for Patient Safety; and co-principal investigator, AHRQ Safety Program for Improving Surgical Care and Recovery.
In addition to faster recovery times, surgical patients can benefit from safer surgical practices and an overall better patient experience when they undergo operations in participating hospitals.
Hospitals interested can initiate the process now in order to have sufficient time to enroll by September 1, 2019.