DGMC ranks in top 10 percent of surgery programs

  • Published
  • By Merrie Schilter-Lowe
  • 60th Air Mobility Wing Public Affairs

TRAVIS AIR FORCE BASE, Calif. -- Out of 680 hospitals in the nation, David Grant USAF Medical Center is one of 68 to achieve “meritorious” status in the American College of Surgeons National Quality Improvement Program for 2016, according to a Sept. 19 ACS announcement. 

The goal of ACS NSQIP is to reduce surgical infection, illness and death related to a surgical procedure and provide a foundation for surgeons to apply the best scientific evidence to the practice of surgery. 

This is the second consecutive year that the medical center at Travis Air Force Base, California, has achieved this rating, “and DGMC is the only Department of Defense site to achieve this for two years in a row,” said Col. (Dr.) Rachel Hight, 60th Surgical Operations Squadron commander.

Hight called the recognition “an enormous team effort.”

Col. (Dr.) Michael Higgins, 60th Medical Group commander, also attributed the recognition to the entire DGMC team of clinicians, support staff and patients. 

“This rating is important to our team as an external benchmark and validation of our focus and commitment to the highest standards of care,” said Higgins. “While far from perfect, we aim each day to earn trust from our patients through open and transparent communication with a focus on safety and quality.”    

Hospitals that participate in NSQIP can expect not only to prevent surgical complications, but also save lives and reduce medical costs. 

“ACS NSQIP is focused only on the rate of complications following surgery,” said Maj. (Dr.) Scott McCusker, 60th SGCS.  “NSQIP is very much clinically focused and outcomes-based.”

McCusker and Maj. (Dr.) Jane Alston, 60th SGCS, headed the medical center’s NSQIP efforts.

The ACS considered a representative sample of surgical cases performed at DGMC and evaluated results for eight outcomes, including mortality, renal failure, cardiac incidents, pneumonia, surgical site infections, urinary tract infections and unplanned intubation, which means a patient’s breathing tube must be reinserted after surgery is complete.  Hospitals are required to track this data and analyze the results.

“It gives us a grade on how well we are able to avoid common complications after surgery and we use this data to target process improvement measures so that they can be most effective,” said McCusker. 

Since DGMC joined NSQIP about seven years ago, there has been “a sustained decrease” in catheter-related infections, which is a common and costly complication, said McCusker.  

DGMC currently is focusing on decreasing repeat operations and readmission of patients.   

“These are difficult, multifactorial problems that won't be solved overnight or with one simple project,” said McCusker. 

“Our current aim is to standardize and streamline the inpatient phase of postoperative care.  This is part of a multi-year military health service-wide collaborative project called the Surgeons Leading Quality Program. 

“The program dovetails with an ACS program to help surgery patients recover quicker so they can get back to normal life sooner,” added McCusker.

By reducing adverse risk to patients, DGMC also can reduce the cost of a hospital stay following surgery.  Currently, that is a minimum of $5,000 per day. 

“Our current goal is to reduce average post-op stay by half a day, which may not sound like a lot but translates into multiple millions of dollars over a year,” said McCusker.

With an operating staff of about 40 surgeons and 300 squadron members, DGMC performs about 2,500 surgeries per year.

Attaining ACS recognition means that the medical center “is significantly safer than the large majority of hospitals across the country, including the highest-ranked civilian hospitals,” said McCusker.

“And winning two years in a row shows that we are committed to maintaining this pattern of excellence and that the first award wasn't just a fluke.”

The recognition also bolsters DGMC’s argument that it is “the flagship of Air Force Medicine as we are the only Air Force site and the only DOD site to be named twice in a row.” 

“Bottom line: We're not just talking about ‘trusted care,’ we're delivering it and have objective data to back up that claim,” said McCusker. 

ACS is a scientific and educational organization founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients.  The college has more than 80,000 members and is the largest organization of surgeons in the world, according to the agency’s website.