2023 Quality Improvement

The 2023 MSQC Quality Initiatives are aimed at laying the foundation for future QI work. Sites will select one of three new project options: Surgical Urinary Catheter Care Enhancement Safety Study (SUCCESS), Frailty Pathway, or Appropriate Preoperative Screening for Low-Risk Surgeries. In addition, every site will select their own site-directed outcome measure. By reviewing prior year outcomes data, hospitals will identify a specific outcome where they have opportunity for improvement.

Option A: SUCCESS Project

Noninfectious complications related to the trauma of catheter placement and removal are as common as urinary tract infections – and often have long-lasting consequences for patients with abnormal bladder emptying and discomfort. This project will measure perioperative urinary catheter use and duration, urinary catheter-related injury/trauma, and urinary retention. It will also focus on implementing strategies to improve the safety of perioperative urinary catheters, reduce catheter use and catheter-associated complications, and improve postoperative urinary retention management.

Option B: Frailty Pathway Project

The focus of this project will be to implement a system for screening vulnerable patients for frailty using a validated screening tool. The goal will be to use the information gathered during the screening process to guide a discussion among patient, family, caregivers and surgeon about the risks, benefits and desired outcomes of surgical versus non-surgical interventions. Each site will check compliance with using the selected validated screening tool as well as documentation of a guided conversation between the surgeon and patient/caregivers following screening and prior to surgery. Going forward, the information gathered during the frailty pathway pilot year will inform and direct interventions for patients identified as frail in future projects.

Option C: Appropriate Preoperative Screening for Low-Risk Surgeries Pilot Project

Eliminating unnecessary, routine preoperative testing before low-risk surgery represents a key opportunity to improve quality, safety, and value in surgery. The work of this project will be integral to identifying the underlying reasons for overuse of preoperative testing in low-risk surgeries, as well as interventions to heighten awareness and reduce variation among hospitals. Sites will: 1) abstract preoperative testing variables on low-risk surgical cases, 2) implement a standard protocol defining appropriate use of preoperative testing, 3) employ strategies to promote adoption of the protocol, and 4) analyze MSQC, MVC, and internal data reports to monitor progress.