April 2016News

High score for patients’ prompt discharge after liver surgery

JGH patients who undergo a liver resection—removal of a large portion of the organ due to cancer—have among the shortest hospital stays for this procedure in North America, says a report by an organization that compiles statistics about surgery at hundreds of Canadian and American hospitals.

The JGH’s performance in this area has been deemed “exemplary”, says Dr. Tsafrir Vanounou, a surgeon in the Division of General Surgery. “To achieve this level of quality is impressive.”

The U.S.-based National Surgical Quality Improvement Program (NSQIP), to which the JGH subscribes, gathers an abundance of detailed data about many types of surgery in healthcare facilities across Canada and the United States. To allow comparisons to be made, the data are adjusted to account for numerous variables, including the institutions’ sizes and patient populations.

This enables the JGH and other subscribers to better understand how they rank against one another, where they excel and where improvement is needed. Based on these benchmarks, changes are implemented where necessary, resulting in improvements to the quality of surgical treatment and the patient experience.

According to Dr. Vanounou, the average length of stay for a major liver resection at the JGH—from operation to discharge—is four to five days.

Your support is vital for better surgery

The JGH is one of only three hospitals in Canada to have adopted the National Surgical Quality Improvement Program. Private funding has been and continues to be essential in supporting the hospital’s participation in NSQIP, including establishing the proper infrastructure, acquiring technology and hiring staff.

Donations to a $5 million endowment fund are crucial, enabling NSQIP to benefit from a stable, permanent source of financial support. This fund will support management experts and clinical research coordinators, as well as the development and implementation of a continuing education program for JGH surgical staff, and the extension of the program to all surgical disciplines.

For more information or to make a donation, please contact the JGH Foundation online or at 514-340-8251.

However, NSQIP tracks the patient over a longer period, from admission until 30 days after discharge. It also follows patients who are transferred from Surgery to other departments, such as Intensive Care.

“It’s fine to discharge someone promptly,” says Dr. Vanounou, “but what good is it if, shortly after the operation, the patient needs to be readmitted? Our high score means not only that the surgery went well, but that readmissions were low. It also reflects the fact that complications, such as blood clots, wound infections and pneumonia, were kept to a minimum.”

He notes that credit for this performance “goes to the entire team. A successful outcome depends on coordinated teamwork from the anesthetist, the OR nurses, the floor nurses, physical and occupational therapists, and social workers. Without this team effort, none of this would be possible.”

NSQIP’s statistics are so useful that Dr. Vanounou says the hospital has now joined the organization’s hepatobiliary section to measure a wider range of surgical procedures of the liver and pancreas. “We believe we’re doing good work. If so, we want to be able to prove it, and if not, we want to understand why, and how to improve.”

Is Dr. Vanounou happy with the statistics on liver resections? “Very happy!” he exclaims. “But are we content with our results? No. We obviously want to continue to do better. Our mission is to become the best liver and pancreas department in Montreal, in Quebec and, if possible, in Canada.”

TD

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