Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study
Background: This study aims to quantitatively assess use of the NSQIP surgical risk calculator (NSRC) in contemporary surgical practice and to identify barriers to use and potential interventions that might increase use. Materials and methods: We performed a cross-sectional study of surgeons at seve...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-06-01
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| Series: | Surgery in Practice and Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666262023000190 |
| _version_ | 1827931777280245760 |
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| author | Samuel M. Miller Sara Abou Azar James S. Farrelly Garrett A. Salzman Meaghan E. Broderick Katherine M. Sanders Vincent P. Anto Nathan Patel Alfredo C. Cordova Kevin M. Schuster Tyler J. Jones Lisa M. Kodadek Cary P. Gross John M. Morton Ronnie A. Rosenthal Robert D. Becher |
| author_facet | Samuel M. Miller Sara Abou Azar James S. Farrelly Garrett A. Salzman Meaghan E. Broderick Katherine M. Sanders Vincent P. Anto Nathan Patel Alfredo C. Cordova Kevin M. Schuster Tyler J. Jones Lisa M. Kodadek Cary P. Gross John M. Morton Ronnie A. Rosenthal Robert D. Becher |
| author_sort | Samuel M. Miller |
| collection | DOAJ |
| description | Background: This study aims to quantitatively assess use of the NSQIP surgical risk calculator (NSRC) in contemporary surgical practice and to identify barriers to use and potential interventions that might increase use. Materials and methods: We performed a cross-sectional study of surgeons at seven institutions. The primary outcomes were self-reported application of the calculator in general clinical practice and specific clinical scenarios as well as reported barriers to use. Results: In our sample of 99 surgeons (49.7% response rate), 73.7% reported use of the NSRC in the past month. Approximately half (51.9%) of respondents reported infrequent NSRC use (<20% of preoperative discussions), while 14.3% used it in ≥40% of preoperative assessments. Reported use was higher in nonelective cases (30.2% vs 11.1%) and in patients who were ≥65 years old (37.1% vs 13.0%), functionally dependent (41.2% vs 6.6%), or with surrogate consent (39.9% vs 20.4%). NSRC use was not associated with training status or years in practice.Respondents identified a lack of influence on the decision to pursue surgery as well as concerns regarding the calculator's accuracy as barriers to use. Surgeons suggested improving integration to workflow and better education as strategies to increase NSRC use. Conclusions: Many surgeons reported use of the NSRC, but few used it frequently. Surgeons reported more frequent use in nonelective cases and frail patients, suggesting the calculator is of greater utility for high-risk patients. Surgeons raised concerns about perceived accuracy and suggested additional education as well as integration of the calculator into the electronic health record. |
| first_indexed | 2024-03-13T06:57:39Z |
| format | Article |
| id | doaj.art-21e054c7d7b74ef699713b480034f3c8 |
| institution | Directory Open Access Journal |
| issn | 2666-2620 |
| language | English |
| last_indexed | 2024-03-13T06:57:39Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj.art-21e054c7d7b74ef699713b480034f3c82023-06-07T04:49:48ZengElsevierSurgery in Practice and Science2666-26202023-06-0113100173Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods studySamuel M. Miller0Sara Abou Azar1James S. Farrelly2Garrett A. Salzman3Meaghan E. Broderick4Katherine M. Sanders5Vincent P. Anto6Nathan Patel7Alfredo C. Cordova8Kevin M. Schuster9Tyler J. Jones10Lisa M. Kodadek11Cary P. Gross12John M. Morton13Ronnie A. Rosenthal14Robert D. Becher15Department of Surgery, Yale School of Medicine, United States; National Clinician Scholars Program, Yale School of Medicine, United States; Corresponding author at: Department of Surgery, Yale School of Medicine, 333 Cedar Street, PO Box 208088, New Haven, CT 06520-8088, United States.Department of Surgery, Yale School of Medicine, United StatesDepartment of Surgery, Quinnipiac University School of Medicine, United StatesDepartment of Surgery, David Geffen School of Medicine, University of California Los Angeles, United States; Department of Surgery, Greater Los Angeles Veterans Affairs Healthcare System, United StatesDepartment of Surgery, Stamford Health System, United StatesDepartment of Surgery, UCSF School of Medicine, United StatesDepartment of Surgery, University of Pittsburgh School of Medicine, United StatesDepartment of Surgery, Wake Forest School of Medicine, United StatesDepartment of Surgery, The Ohio State University College of Medicine, United StatesDepartment of Surgery, Yale School of Medicine, United StatesDepartment of Surgery, Yale School of Medicine, United StatesDepartment of Surgery, Yale School of Medicine, United StatesDepartment of Medicine, Yale School of Medicine, United StatesDepartment of Surgery, Yale School of Medicine, United StatesDepartment of Surgery, Yale School of Medicine, United StatesDepartment of Surgery, Yale School of Medicine, United StatesBackground: This study aims to quantitatively assess use of the NSQIP surgical risk calculator (NSRC) in contemporary surgical practice and to identify barriers to use and potential interventions that might increase use. Materials and methods: We performed a cross-sectional study of surgeons at seven institutions. The primary outcomes were self-reported application of the calculator in general clinical practice and specific clinical scenarios as well as reported barriers to use. Results: In our sample of 99 surgeons (49.7% response rate), 73.7% reported use of the NSRC in the past month. Approximately half (51.9%) of respondents reported infrequent NSRC use (<20% of preoperative discussions), while 14.3% used it in ≥40% of preoperative assessments. Reported use was higher in nonelective cases (30.2% vs 11.1%) and in patients who were ≥65 years old (37.1% vs 13.0%), functionally dependent (41.2% vs 6.6%), or with surrogate consent (39.9% vs 20.4%). NSRC use was not associated with training status or years in practice.Respondents identified a lack of influence on the decision to pursue surgery as well as concerns regarding the calculator's accuracy as barriers to use. Surgeons suggested improving integration to workflow and better education as strategies to increase NSRC use. Conclusions: Many surgeons reported use of the NSRC, but few used it frequently. Surgeons reported more frequent use in nonelective cases and frail patients, suggesting the calculator is of greater utility for high-risk patients. Surgeons raised concerns about perceived accuracy and suggested additional education as well as integration of the calculator into the electronic health record.http://www.sciencedirect.com/science/article/pii/S2666262023000190NSQIP surgical risk calculatorHigh-risk patientsRisk assessmentSurgical decision-making |
| spellingShingle | Samuel M. Miller Sara Abou Azar James S. Farrelly Garrett A. Salzman Meaghan E. Broderick Katherine M. Sanders Vincent P. Anto Nathan Patel Alfredo C. Cordova Kevin M. Schuster Tyler J. Jones Lisa M. Kodadek Cary P. Gross John M. Morton Ronnie A. Rosenthal Robert D. Becher Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study Surgery in Practice and Science NSQIP surgical risk calculator High-risk patients Risk assessment Surgical decision-making |
| title | Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study |
| title_full | Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study |
| title_fullStr | Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study |
| title_full_unstemmed | Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study |
| title_short | Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study |
| title_sort | current use of the national surgical quality improvement program surgical risk calculator in academic surgery a mixed methods study |
| topic | NSQIP surgical risk calculator High-risk patients Risk assessment Surgical decision-making |
| url | http://www.sciencedirect.com/science/article/pii/S2666262023000190 |
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