For each surgical case, 152 variables
are collected:
9 Demographic variables
11 Surgical Profile variables
Preoperative variables
- 4 demographic
- 42 clinical
- 26 laboratory
Intraoperative variables
Postoperative variables
- 7 occurrence
- 12 laboratory
- 9 discharge
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The ACS NSQIP involves the collection of preoperative risk factors,
intraoperative variables, and postoperative outcomes by a
Surgical Clinical Nurse Reviewer (SCNR) at each participating
medical center. The nurses are carefully trained on procedures
for selection of patients, and recording of the data using
standardized definitions in an operations manual.
The patient population consists of all patients undergoing a
major surgical procedure under general, spinal, or epidural
anesthesia. Operations upon patients who had been previously
entered into the database for an index surgical procedure within
the previous 30 days, and certain minor operations with known
very low mortality and morbidity rates are excluded. All
major operations are entered into the ACS NSQIP database from medical centers
with small to medium volumes. For high volume centers, the
first 40 consecutive cases are entered in each 8-day cycle,
beginning with a different day each week. Certain very high-volume
procedures (hernias, TURPs, and TURBTs) are limited to the
first 5 procedures in each 8-day cycle.
Preoperative, operative, and postoperative variables were chosen
on the basis of clinical relevance, reliability of data collection
by the nurses, and the availability and ease of data collection.
Preoperative data include patient demographics and comorbidities
collected from the patient’s preoperative history and
physical examination. Selected preoperative laboratory values
closest to the time of the index surgical operation are also
collected. Operative variables are obtained from the operative
log and anesthesia record. Outcome variables include vital status
and several different postoperative complications that have
uniform definitions, occurring within 30 days after the operation.
These data are obtained from the patient’s medical chart,
morbidity & mortality conferences, and by patient contact
through mail or telephone on the 30th postoperative day. The
ACS NSQIP protocol adheres to HIPAA standards for patient confidentiality.
All submitted data are stripped of any patient identifiers
and all reports that are shared among participants are blinded
by medical center. Additionally, the ACS NSQIP does not capture
any physician identifiers as the focus of the program is on
the systems of care and quality improvement, not on the individual
surgeon’s performance.
QCMetrix has developed a training curriculum for the Surgical
Clinical Nurse Reviewers, as well as a number of online tools
and systems to collect the data in a rigorously defined and
consistently applied manner. To learn more, click below:
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