Growing focus on surgical outcomes

Thursday, November 3, 2022

Surgeons and perioperative nurses from across Eastern Australia will descend on Brisbane later this month at the first inter-jurisdictional Surgical Quality Improvement Program Collaborative meeting.

The National Surgical Quality Improvement Program (NSQIP) is modelled on the American College of Surgeons’ program of the same name and was first introduced in New South Wales in 2015. NSQIP provides a snapshot of a hospital’s surgical outcomes compared against local and international peers in one of the largest international outcome databases ever created. These results enable targeted quality improvement initiatives to be developed to enhance the quality of surgical care while reducing complications and costs.

“Without the ability to analyse data it’s very difficult to identify and fix any problem areas,” Dr Robert Franz, Chair of CEQ’s Surgical Advisory Committee (SAC) said.

Queensland introduced NSQIP in 2019 with 13 Queensland hospitals currently participating. Victoria and Tasmania Health are exploring joining the collaborative this year, bringing the total number of sites participating nationally to more than 30. The meeting of collaborative members – scheduled for November 24 - is the first time all four states will come together to discuss surgical quality improvement.

The event will be an opportunity to discuss findings and improvements to surgical services that have been initiated as a result of international benchmarking.

“Nurses phone patients 30 days after discharge to follow up on their outcomes. We ask questions about many different types of surgical-related morbidity, pick up on readmissions and the reason for readmission, or the reason they attended an emergency department,” Dr Franz said. Nurses make up to 40 calls a week and are required to have special credentialing. Interviews can take anywhere from 20 minutes to an hour to complete.

“The data is invaluable as it enhances our ability to zero in on preventable complications, using validated, risk-adjusted clinical and administrative data that we would never ordinarily have access to without the program.”

Dr Franz said while it can be confronting to see your own surgical team’s outcomes reported so clearly, it is an important opportunity to improve clinical practice.

Dr Helen Brown, Deputy Director-General Clinical Excellence Queensland said CEQ was proud to support the team-led, system-level approach to reducing surgical complications. “We provide seed funding to get hospitals started with the program and assist with coordinating the collaborative and with interpreting the twice-yearly reports.”

Dr Brown said based on a large hospital performing an average of 1,600 procedures a year, it can take two-to-three years to get sufficient data. “It can take a few years to get appropriate data with a good confidence interval, so the sooner you start, the sooner you can join your colleagues in improving the quality of care you provide,” Dr Brown said. “I strongly encourage all sites to participate,” she said.

To find out more about the collaborative or NSQIP, email

Last updated: 3 November 2022