Frequently Asked Questions about ACS NSQIP Pediatric

ACS NSQIP Pediatric is a nationally validated, risk-adjusted, outcomes-based approach to measure and improve surgical care for pediatric patients. Currently, 60 hospitals use the ACS NSQIP Pediatric tools, analyses, reports, and support to make informed decisions about improving quality of care.

ACS NSQIP Pediatric has continued to grow in variables, data collection, reports, and participation. Sites are guided through quality improvement efforts and the collection of 1,400 cases a year. These efforts lead to lower costs and better outcomes.

ACS NSQIP Pediatric is a multispecialty, procedure-targeted program, which benefits participating hospitals by allowing them to collect data on specific, high-risk, high-volume procedures drawn from 6 subspecialty areas.

This also includes data collection on Surgical Antibiotic Prophylaxis, Surgical Opioid Stewardship, and Process Measures for urgent surgical conditions in children. Participants can focus their QI efforts on areas that will yield the greatest return on investment, as well as define important benchmarks for quality within their specialty.

ACS NSQIP Pediatric is open to all pediatric hospitals, including free-standing general acute care children’s hospitals, children’s hospitals within a larger hospital, specialty children’s hospitals, or general acute care hospitals with a pediatric wing.

By having access to powerful tools and a proven process to assess and improve their surgical quality, hospitals benefit. Sites can share what they have learned with other participating sites and build on lessons learned. There is also a significant opportunity to reduce costs and improve profit margins by reducing complications.

The data collected relies on clinical data from highly trained and certified abstractors, not claims data from billing files. Claims data doesn’t allow for researchers to adjust for patient risk factors or if the patient experienced a complication after leaving the hospital. 

ACS NSQIP Pediatric uses risk-adjusted data from medical charts that includes an assessment of the patient’s condition 30 days after a procedure. This allows hospitals to make a valid comparison with other hospitals and determine where it needs to make improvement. 

Because it captures data prospectively, it takes ACS NSQIP Pediatric sites approximately 6–12 months to capture enough data to be able to make meaningful comparisons to other sites. Factors such as how many surgical clinical reviewers (SCRs) the site has, and the presence or absence of data automation will also affect the volume of cases submitted and the subsequent speed the site will have enough data to draw conclusions.

With an enthusiastic hospital administration on board, it’s important to identify a surgeon champion who will be the lead in obtaining administrative approval in implementing the program. In addition, determining the sources of funding for the program (like hiring a full-time SCR and paying the program fee) in advance will help the process run smoothly.

No, pediatrics is a separate program from the adult program. The pediatric program requires that an SCR be hired specifically so that enough data can be captured to result in meaningful information for the hospital. Pediatrics is a separate contract from adult NSQIP. Hospitals may assess shared resources across the adult and pediatric programs.

A Performance Improvement and Patient Safety (PIPS) program is required for hospitals seeking verification. These centers MUST have a multidisciplinary center-wide performance improvement process for children’s surgery. Institutional performance MUST be examined relative to external norms, with demonstrable loop closure.

Yes, outpatient surgical procedures that are performed at an ACS NSQIP Pediatric-enrolled hospital will be included in the sample. Surgery centers that perform only outpatient operations will not be eligible to enroll in the program.

ACS NSQIP Pediatric and the program committees have taken this fact into consideration and have therefore selected certain operations that will be restricted in the sampling plan to avoid overwhelming the sample with low morbidity and low mortality procedures. For example, the inclusion of procedures such as appendectomy, laparoscopic cholecystectomy, and gastrostomy are restricted to a certain volume.