Case Analysis - Veterans Health Administration: Nsqip Program

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Case Analysis
Veterans Health Administration: NSQIP Program
Lora K. Jackson
Keller Graduate School of Management
July 16, 2011

Case Analysis - Veterans Health Administration: NSQIP Program

Purpose of Study

“The Veterans Health Administration: NSQIP Program” (Ball, Weaver, Kiel; 2004) was a physician-driven comparison study initiated by senior surgeons between 1991 and 1997, in which mortality and morbidity rates were “risk adjusted and compared to observed-to-expected ratios”. They studied data in order to determine the efficacy of surgical procedures from the pre-operative- through 30-day post-operative periods. This study was intended to improve the quality of care provided to patients throughout the Veterans Administration Medical Centers (VAMC) nationwide during the operative periods stated above by utilizing the National VA Surgical Risk Study (NVASRS). The information technology (IT) system, VISTA, is an electronic medical record system developed by the VHA which uniformly connects the entire VAMC system and was utilized in the compilation of the necessary data. They intended to show that the quality of care provided for the patients was equal to the outcomes produced within the study and initiated solid evidenced-based practice (EVP) protocols to ensure improvement of outcomes.

Improvements were noted across the spectrum after the program was initiated. The 30-day mortality rate improved by 9.6%, the 30-day morbidity rate by 30% and length of stays decreased from 10.2 days to 5.1 days (a full 50% improvement). The VAMC sites with the greatest improvements also noted a significant improvement in patient satisfaction. Comparative Studies

1) “Patient Safety. Validity of Selected AHRQ Patient Safety Indicators Based on VA National Surgical Quality Improvement Program Data” (2009) by Romano, Mull, Rivard is a comparative study in which the NSQIP data at VAMC’s during fiscal year 2001 is merged with AHRQ Patient Safety...
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