By Aaron Mahoney (@Mahones93 on Twitter)

Surgery program at CRH earns commendation from American College of Surgeons

Dec 10, 2018 | 11:24 AM

LETHBRIDGE – The Chinook Regional Hospital is the only hospital in Alberta, and just one of 83 hospitals worldwide, to be commended by the American College of Surgeons for exemplary surgical outcomes.

The college’s National Surgical Quality Improvement Program selected the local Alberta Health Services facility from more than 800 participating hospitals around the world.

About 10,000 surgeries, including day surgeries, are performed annually at Chinook Regional Hospital, which joined the National Surgical Quality Improvement Program in 2014.

Dr. Jack Regehr, AHS South Zone Medical Director says they’re tremendously grateful to nurses, hospital staff, physicians and surgeons for the great job they do in going above and beyond to serve patients.

“This program and award demonstrate that great care is safe, efficient and cost-effective as well. We appreciate our patients and staff putting up with constant change as we continue to strive to reach ever higher standards of care.”

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The program’s goal is to reduce infections, illnesses and deaths related to surgical procedures by providing surgical teams with the best, most current evidence related to the practice of surgery.

Hospital anesthesiologist Dr. Melissa Setiawan explains they received something called Meritorious Status from the National Surgical Quality Improvement Program, which is basically like being on the honour roll for the world of surgical programs.

“It’s based on outcomes, and we’re compared to other hospitals of similar types of size and population base. They do a lot of fancy statistics to kind of match us up and adjust for our risks and other factors. Then when they look at all those numbers and compare them, we’ve actually done well, we’re in the top 80 or so hospitals in the world,” Setiawan said.

Reducing infections is a huge piece of the work done by surgeons at CRH, and Setiawan says surgical site infections are such a big problem because not only is it an issue for patients having to come back to the hospitals and take time off work, but also for the surgeons.

“This is a big improvement because when we first started the program, we did have some numbers where we could have improvements in this area. Since we started looking at making small tweaks in the ways we give patient care, we’ve improved significantly. It means that patients can feel comfortable that they’re getting really good, quality care and when they have an operation, we’re doing our best to prevent future complications.”

Chinook Regional Hospital tracks surgical outcomes and uses the data to identify opportunities for improvement in the quality of surgical care. Dr. Luke Szobota, the surgical champion for the NSQIP program, describes the program itself as a kind of grounds up approach.

“So, we follow patients through the system, we collect variables and data on them, and then we get outcomes. Those outcomes are then compared to other hospitals in the program in North America and throughout the world. When we identify areas that we can improve on, we then enacted quality improvement programs.”

One of the examples Szobota gave was making sure everyone gets the right antibiotic at the right time just before surgery in order to decrease the chance of a surgical site infection.

“There are many other areas that we look at as well, and when you kind of focus on areas where you can most improve, this improves the overall outcome for patients in terms of decreasing the chance of infections, urinary problems, cardiac complications, respiratory complications,” he continued. “It allows us to really hone in our resources in areas that we can make improvements.”

Among the surgery-related improvements reported at Chinook Regional Hospital between 2016 and 2017:

– The rate of postoperative infections (all types of surgeries) went from 2.76 percent in 2016 to 2.02 percent in 2017, a 27 percent reduction, placing Chinook Regional Hospital in the top third of participating hospitals.

– The 30-day re-admission rate for general surgery patients went from 22 events in 2016 to 12 events in 2017, placing Chinook Regional Hospital in the top 10 percent of all participating hospitals.

– Out of 541 orthopedic surgeries in 2017, there were no cardiac complications, due in part to improved pre-operative assessments that aim to better prepare patients prior to surgery (there were none in 2016 either).

Last year, the hospital also had no cardiac complications for all types of surgery; there were five cardiac events for all types of surgery in 2016.

The 83 commended hospitals achieved the distinction based on their outstanding quality scores across eight areas, including mortality, renal failure, pneumonia, cardiac incidents, surgical site infections and urinary tract infections.

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient.