Sustained culture and surgical outcome improvement

Bruna Babic; Anita Ayrandjian Volpe; Stephen Merola; Elizabeth Mauer; Yaniv Cozacov; Clifford Y Ko; Fabrizio Michelassi; Pierre Saldinger

doi:10.1016/j.amjsurg.2018.02.016

Sustained culture and surgical outcome improvement

Am J Surg. 2018 Nov;216(5):841-845. doi: 10.1016/j.amjsurg.2018.02.016. Epub 2018 Feb 16.

Authors

Bruna Babic¹, Anita Ayrandjian Volpe², Stephen Merola³, Elizabeth Mauer⁴, Yaniv Cozacov², Clifford Y Ko⁵, Fabrizio Michelassi⁶, Pierre Saldinger³

Affiliations

¹ Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA; Department of Surgery, Weill Cornell Medicine, New York, NY, USA. Electronic address: brb2019@med.cornell.edu.
² Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA.
³ Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA; Department of Surgery, Weill Cornell Medicine, New York, NY, USA.
⁴ Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, New York-Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
⁵ Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL, USA.
⁶ Department of Surgery, Weill Cornell Medicine, New York, NY, USA.

PMID: 29482831
DOI: 10.1016/j.amjsurg.2018.02.016

Abstract

Background: A focus on the culture of safety and patient outcomes continues to grow in importance. Several initiatives targeted at individual deficits have been described but few institutions have shown the effect of a global change in culture on patient outcomes.

Methods: Patient care perception was assessed using Safety Attitudes Questionnaire (SAQ) by Pascal Metrics^®. A change in culture was initiated, followed by implementation of initiatives targeting communication and patient safety. ACS-NSQIP data was analyzed to assess outcomes during the period of improved culture.

Results: Our institution had poor outcomes as measured by ACS-NSQIP data and several deficiencies in our culture score. Both statistically improved after initiative implementation. A difference in mean culture score across time (p < 0.001 = .031) was seen from 2013 to 2015, while NSQIP odds ratios falling in the 'exemplary' category increased.

Conclusion: Our results demonstrate an improvement in both culture and outcomes from 2013 to 2015, suggesting a correlation between culture and surgical outcomes.

Keywords: Culture; NSQIP; Patient quality improvement; Patient safety; Surgical quality improvement.

MeSH terms

Culture*
Female
Humans
Male
Patient Safety / standards*
Postoperative Complications / epidemiology
Postoperative Complications / prevention & control*
Quality Improvement / organization & administration*
Quality Indicators, Health Care*
Surgical Procedures, Operative / standards*
Treatment Outcome
United States / epidemiology