First Report of a Multiphase Pilot to Measure Patient-Reported Outcomes in the American College of Surgeons National Surgical Quality Improvement Program

Background: Incorporating the patient's perspective to evaluate national surgical quality has yet to be achieved in the United States and represents a tremendous unrealized opportunity for continuous quality improvement. The first phase of a multiphase pilot to measure patient-reported outcomes (PROs) using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) is described.

Methods: After conducting a baseline knowledge assessment and stakeholder engagement activities, a pilot to capture PROs was implemented using the ACS NSQIP platform. Hospital participation was voluntary. A 45-item survey was compiled from three validated PRO measures and administered electronically to patients accrued into the ACS NSQIP registry. Constructs measured were overall health-related quality of life, pain interference, and experiences of care. Lessons learned during implementation were compiled, and preliminary data analyses were conducted.

Results: Between October 2017 and March 2018, 1,324 patients from 17 hospitals in the United States and Canada responded to the survey. Responding patients underwent 348 different types of operations, varying in complexity and riskiness. The median age of respondents was 63 years (interquartile range: 52-70), and the survey took on average 6.4 minutes to complete. Hospital response rates ranged from 10% to 50% with a 20% median.

Conclusion: The implementation of this first phase demonstrates that the measurement of PROs is possible using the ACS NSQIP and that the barriers-perceived or real-can be reasonably overcome.