AHRQ Safety Program opens enrollment for hospitals

The American College of Surgeons issued a national call forinterested hospitals to join a new cohort of the Agency for Healthcare Researchand Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery(ISCR). Presented in collaboration with the Johns Hopkins Medicine ArmstrongInstitute for Patient Safety and Quality, the ISCR program enables hospitals toimplement enhanced recovery pathways, which have been shown to improve safety,decrease complications, shorten recovery times, and reduce length of stay forsurgical patients. The program is funded and guided by AHRQ.

The next group ofenrollees, who will participate in Cohort 3B, can begin participation onSeptember 1, 2019. Due to strong interest in the previous cohort, the advancedenrollment period for hospitals has been lengthened, and is now open. Onceenrolled, participating hospitals will have access to tools for implementingenhanced recovery pathways for colorectal, gynecology, total joint replacementand hip fracture pathways.

The AHRQ ISCR program seeks to improve surgical patientoutcomes by increasing the implementation of enhanced recovery practices inparticipating hospitals through the use of an adaption of AHRQ’s ComprehensiveUnit-based Safety Program (CUSP), a model for sustainable safety improvementthat has been associated with preventing harm in multiple areas. There is nocost to participate in the program.

“This program provides protocols and strategies forhospitals to improve their surgical outcomes. Even if they are already usingsome enhanced recovery protocols, we have identified specific opportunitiesthat help hospitals become even better. We invite all interested hospitals toenroll so they have full access to the program’s resources, support andclinical experts,” said Clifford Y. Ko, MD, MHS, FACS, director of the ACSDivision of Research and Optimal Patient Care.

Since the start ofthe first cohort in July 2017, the AHRQ ISCR program has actively supportedparticipants in implementing evidence-based surgical care. The initial cohortfocused on colorectal operations. The second cohort, launched in March 2018,expanded the program’s work to include total joint replacement and hip fractureoperations. A third cohort, started in March 2019, provided a new area of focusfor gynecologic procedures.

This comprehensiveprogram allows participating hospitals to work to improve surgical patientoutcomes, reduce length of stay, prevent complications, increase reliabilityand standardization of care, improve efficiency, and improve surgical teamworkand the hospital’s surgical care culture.

“It’s key to the American College of Surgeons’ mission tobring forth to the nation this proven quality approach for improving surgicalcare and recovery,” David B. Hoyt, MD, FACS, ACS executive director. “Not onlydoes this program provide a steady path forward for hospitals to easilyparticipate, we’re now expanding the number of surgical procedures for surgicalteams to focus on.”

Participating hospitals receive a ready-to-use pathway,access to education materials on how to implement the pathway, access toexperts in performance improvement and education who will help themtroubleshoot as they implement, and inclusion in a community of surgeons andperioperative teams rolling out the same pathway.

Enrolled hospitalsalso have the opportunity to join monthly coaching calls and national leaderwebinars to learn from their colleagues and other experts in the field.Coaching calls are discussion driven on topics such as patient and staffeducation, specific clinical practice area changes such as bowel preparation ormultimodal analgesia, and barriers to and facilitators of implementation,including such issues as coordinating multidisciplinary teams, communicatingand working across units, surgeon engagement, or the electronic health record.National leader webinars are clinically focused. Topics have included bowelprep versus oral antibiotics, preoperative lab testing, venous thromboembolismprophylaxis, building a culture of mobility, and delirium screening.

“This program canhave a remarkable impact on improving surgical care across the U.S. Fewercomplications, shorter hospital stays, lower costs. It’s all possible whensurgical patient care is delivered within an enhanced recovery framework,” saidElizabeth Wick, MD, FACS, who is affiliated with Johns Hopkins MedicineArmstrong Institute for Patient Safety; and co-principal investigator, AHRQSafety Program for Improving Surgical Care and Recovery.

In addition to faster recovery times, surgical patients canbenefit from safer surgical practices and an overall better patient experiencewhen they undergo operations in participating hospitals.

Hospitals interested can initiate the process now in orderto have sufficient time to enroll by September 1, 2019.