Healthcare News & Insights

Hospital collaborative improves surgical outcomes, saves big bucks

A collaborative of 10 hospitals in Tennessee managed to reduce their rates of acute renal failure, surgical site infections and wound disruption, all while saving millions.

How they did it

In 2008, the 10 hospitals decided to participate in the American College of Surgeons’ National Surgical Quality Improvement Program (ACS NSQIP). They joined together to form the Tennessee Surgical Quality Collaborative with funding from the BlueCross BlueShield of Tennessee Health Foundation.

Representatives from each of the 10 facilities met four times a year to compile their information using the ACS NSQIP,  and share their surgical processes and data on surgical outcomes. If they discovered that one facility had better outcomes on a procedure, the other members would visit that facility to see what it was doing that the other facilities weren’t.

After only a few years, the collaborative, which is one of the first of its kind in the U.S., made such progress that its results were published in a study in the Journal of the American College of Surgeons.

The collaborative looked at 20 categories of postoperative complications, 20-day mortality rates and hospital costs associated with postoperative complications in a total of 14,205 surgical cases in 2009 and 14,901 cases in 2010.


Not only did the hospitals in the collaborative reduce their rates of acute renal failure, surgical site infections and wound disruption, but they also saved nearly $2.2 million on 10,000 general and vascular surgery cases studied — comparing 2010 numbers with those from 2009.

The 10,000 cases examined in the report only represented about one-fourth of the total general and vascular surgery cases performed in the TSQC hospitals in 2009 and 2010. If all the cases had been examined, the saving may have been closer to $8 million.

Researchers noted in the study that improvements in surgical outcomes were attributed to two factors:

  • problems were identified and new practices based on evidence-based medicine quickly replaced them for areas such as skin and soft tissue/wound disruption and ventilator management, and
  • special attention being focused on a problem that was uncovered through involvement in ACS NSQIP for areas such as renal and graft failure.

When looking at the overall value of this study, Dr. Oscar Guillamondegui, MPH, FACS, lead author and associate professor of surgery at Vanderbilt University Medical Center in Nashville, summed it up nicely in a press release, “While previous studies have shown that participation in quality improvement programs such as ACS NSQIP have been shown to save lives, improve health and reduce costs, the Tennessee collaborative illustrates that participation in an ACS NSQIP collaborative can accelerate those benefits and take quality improvement to a whole new level.”

Has your facility done something to improve patient outcomes or save costs that you would like profiled? If so, contact me at


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