The power of the National Surgical Quality Improvement Program--achieving a zero pneumonia rate in general surgery patients

Perm J. Winter 2012;16(1):39-45. doi: 10.7812/tpp/11-127.


The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year. This article summarizes briefly the history of NSQIP and how its report on surgical outcomes can be used for performance improvement within a hospital system. In particular, it describes how to drive performance improvement with NSQIP data using the example of postoperative respiratory complications--a major factor of postoperative mortality. In addition, this article explains the benefit of a collaborative of several participating NSQIP hospitals and describes how to develop a "playbook" on the basis of an outcome improvement project.

MeSH terms

  • Cross Infection / etiology
  • Cross Infection / prevention & control*
  • General Surgery / standards*
  • Hospital Mortality
  • Hospitals, Veterans / standards
  • Humans
  • Pneumonia / etiology
  • Pneumonia / prevention & control*
  • Postoperative Complications / prevention & control
  • Quality Improvement / organization & administration
  • Quality Improvement / standards*
  • Surgical Procedures, Operative / adverse effects*
  • United States