1. Surgical Care and Outcomes Assessment Program

2. What is SCOAP? “A quality of care improvement program providing hospital specific data feedback and best practices regarding processes of care and outcomes across the Pacific Northwest” –All stakeholders working together (physicians, quality of care personnel, hospital administrators, purchasers of healthcare, insurers) –Drives QI using meaningful data Thoughtful approach to transparency –Works within a statewide statue that protects confidentiality

3. “Who is behind SCOAP?” Foundation for Healthcare Quality SCOAP Partners and Stakeholders –Washington State Health Care Authority –Washington State Medicaid Assistance Administration –Group Health Cooperative –Premera Blue Cross –Regence Blue Shield –Washington State Hospital Association

4. Seattle Redmond Spokane Yakima Wenatchee Richland Port Townsend Sunnyside Aberdeen Tacoma in Washington State Port Angeles Mount Vernon

5. Participating Hospitals Enrolled and submitting data: Central Washington HospitalCentral Washington Hospital, Wenatchee Children’s Hospital and Regional Medical CenterChildren’s Hospital and Regional Medical Center, Seattle Grays Harbor Community HospitalGrays Harbor Community Hospital, Aberdeen Harborview Medical CenterHarborview Medical Center, Seattle Jefferson HealthcareJefferson Healthcare, Port Townsend Kadlec Medical CenterKadlec Medical Center, Richland Madigan Army Medical CenterMadigan Army Medical Center, Tacoma Sacred Heart Medical CenterSacred Heart Medical Center, Spokane Sunnyside Community HospitalSunnyside Community Hospital, Sunnyside Swedish Health ServicesSwedish Health Services, Seattle University of Washington Medical CenterUniversity of Washington Medical Center, Seattle Virginia Mason Medical CenterVirginia Mason Medical Center, Seattle Wenatchee Valley Medical CenterWenatchee Valley Medical Center, Wenatchee Yakima Valley Memorial HospitalYakima Valley Memorial Hospital, Yakima Enrolled, not yet submitting data: Group Health Cooperative/Eastside HospitalGroup Health Cooperative/Eastside Hospital, Redmond Skagit Valley HospitalSkagit Valley Hospital, Mount Vernon Commitment to enroll: Olympic Medical CenterOlympic Medical Center, Port Angeles

6. SCOAP Development Four procedures to start –Appendectomy, Colectomy/Proctectomy, Gastric bypass –Vascular surgery pilot Focus on important process of care measures for surgeons/hospitals In hospital outcome measures-risk adjustment Data abstracted by local staff/web-based entry Quarterly reporting to surgeons, QI and hospital leadership

7. SCOAP Metrics # 1 Normothermia # 2 Euglycemia # 3 VTE Chemoprophylaxis # 4 Antibiotic Use # 5 Pain Control # 6 Transfusion Use # 7 Post-operative Respiratory Failure # 8 Myocardial Infarction Prevention # 9 Diagnostic Imaging for Appendectomy # 10 Imaging Accuracy for Appendectomy # 11 Operative process # 12 Lymph Nodes Removed for Colon Cancer # 13 Post Operative Interventions # 14 Hospital Stay and Discharge Status # 15 Negative Appendectomy

8. What has SCOAP learned so far? “Baby steps are important” Data show widespread variability –Opportunities for improvement Physician engagement works Data collection only works when its relevant data and fed back to engaged staff working with local QI Local success stories drive regional success stories