Reducing Healthcare Costs Using ACS NSQIP-Driven Quality Improvement Projects: A Success Story from Sheikh Khalifa Medical City (SKMC).

Introduction: Surgical complications increase hospital length of stay and costs and lead to poor patient experience. We aim to evaluate our complication rates over time and the financial impact of joining the adult multi-specialty American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) at Sheikh Khalifa Medical City (SKMC).

Methods: Sheikh Khalifa Medical City is a Joint Commission International-accredited ACS NSQIP member since 2009. For the purpose of quality improvement, we have established several task forces (2010-2014) to decrease high rates of venous thromboembolism (VTE), urinary tract infection (UTI), surgical site infection (SSI), unplanned intubation (UI), and ventilator more than 48 h (Vent > 48 h). Our aim is to evaluate our complication rates over time and calculate the cost savings from prevented occurrences in VTE, UTI, SSI, UI, and Vent > 48 h. Cost savings are calculated using the return on investment calculator from ACS NSQIP. In addition, the cost of joining and maintaining ACS NSQIP at SKMC is calculated to determine the total cost savings after subtracting these costs.

Results: During the study period, we performed 8842 cases (2009-2015) and our overall morbidity improved significantly from observed/expected (O/E) 1.61% to (O/E) 0.85%. We prevented 12 VTE cases (2011-2015), 56 UTI cases (2013-2015), 12 SSI cases (2013-2015), 4 UI cases (2014-2015), and 7 Vent > 48 h cases (2014-2015). The cost saving from all these four task forces was $1,680,000. The cost of joining and maintaining ACS NSQIP at SKMC since 2009 was $336,000. Hence, the total saving for SKMC was $1,344,000.

Conclusion: ACS NSQIP-driven quality improvement projects have resulted in reduction in complications and healthcare costs at SKMC over a 6-year period.