Creating a learning healthcare system in surgery: Washington State's Surgical Care and Outcomes Assessment Program (SCOAP) at 5 years.

There are increasing efforts towards improving the quality and safety of surgical care while decreasing the costs. In Washington state, there has been a regional and unique approach to surgical quality improvement. The development of the Surgical Care and Outcomes Assessment Program (SCOAP) was first described 5 years ago. SCOAP is a peer-to-peer collaborative that engages surgeons to determine the many process of care metrics that go into a "perfect" operation, track on risk adjusted outcomes that are specific to a given operation, and create interventions to correct under performance in both the use of these process measures and outcomes. SCOAP is a thematic departure from report card oriented QI. SCOAP builds off the collaboration and trust of the surgical community and strives for quality improvement by having peers change behaviors of one another. We provide, here, the progress of the SCOAP initiative and highlight its achievements and challenges.

[1]  C. Ko,et al.  Variability in reoperation rates at 182 hospitals: a potential target for quality improvement. , 2009, Journal of the American College of Surgeons.

[2]  H. Polk,et al.  Practicing Surgeons Lead in Quality Care, Safety, and Cost Control , 2004, Annals of surgery.

[3]  Lillian S Kao,et al.  Navigating towards improved surgical safety using aviation-based strategies. , 2008, The Journal of surgical research.

[4]  John N. Lewis,et al.  Opportunities for Improved Performance in Surgical Specialty Practice , 2008, Annals of surgery.

[5]  D. Malenka,et al.  The Northern New England Cardiovascular Disease Study Group: a regional collaborative effort for continuous quality improvement in cardiovascular disease. , 1998, The Joint Commission journal on quality improvement.

[6]  E J Topol,et al.  Outmigration for coronary bypass surgery in an era of public dissemination of clinical outcomes. , 1996, Circulation.

[7]  David C Aron,et al.  Adherence to surgical care improvement project measures and the association with postoperative infections. , 2010, JAMA.

[8]  J. Birkmeyer,et al.  Partnering with payers to improve surgical quality: the Michigan plan. , 2005, Surgery.

[9]  D. Malenka,et al.  Adjusting for patient differences in predicting hospital mortality for percutaneous coronary interventions in the Clinical Outcomes Assessment Program. , 2003, American heart journal.

[10]  D. Flum,et al.  Negative Appendectomy and Imaging Accuracy in the Washington State Surgical Care and Outcomes Assessment Program , 2008, Annals of surgery.

[11]  David R Flum,et al.  Washington State's approach to variability in surgical processes/Outcomes: Surgical Clinical Outcomes Assessment Program (SCOAP). , 2005, Surgery.

[12]  P. Maurette,et al.  [To err is human: building a safer health system]. , 2002, Annales francaises d'anesthesie et de reanimation.

[13]  Richard A Karl.  Navigating towards improved surgical safety using aviation-based strategies. , 2008, The Journal of surgical research.

[14]  J. Wennberg,et al.  Time to tackle unwarranted variations in practice , 2011, BMJ : British Medical Journal.

[15]  David R Flum,et al.  Blueprint for a new American College of Surgeons: National Surgical Quality Improvement Program. , 2008, Journal of the American College of Surgeons.