General surgery

The goal of the Michigan Surgical Quality Collaborative is to evaluate and improve the quality of general and vascular surgery while reducing health care costs. The initiative is outperforming national initiatives in surgical outcomes, including reduction in complications and in surgical site infections.

This initiative has successfully built a large data registry, and has shared and analyzed data to develop evidence-based care processes that reduce complications, improve safety and save valuable health care dollars. For more information, go to msqc.org.

Results

  • Colectomy Procedures (2012-2016)
    • Reduction of 34% in surgical site infection rate
    • Greater than 36% increase on adherence to 3 colectomy bundle elements:
      • Oral antibiotics with bowel preparation
      • Postoperative glucose less than 140mg/dl
      • Prophylactic Antibiotic Selection
  • Colon Cancer (2014-2016)
    • Rate for positive margins has decreased (improved) 8.27%
  • Rectal Cancer (2014-2016)
    • The rate for 12 or more lymph nodes examined increased 4.4%
    • The positive margin rate decreased 2.02%
    • Organ Space surgical site infection has decreased 1.42%
  • Hysterectomy (2012-2014)
    • Developed an evidence based 4-item bundle of care processes (minimally invasive surgical approach, avoidance of hemostatic agents, surgical time <2 hours, and appropriate antibiotics) associated with fewer complications and readmissions.
    • Identified the increased cost of robotic hysterectomy for benign disease ($3,200 per case)
    • Identified decreased rates of superficial site infection and blood transfusion for robotic versus laparoscopic or vaginal hysterectomy.