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CERTAIN & SCOAP: A Partnership for a Learning Healthcare System

On Friday, June 14, CERTAIN participated in the 6th Annual SCOAP Retreat at Campbell’s Resort in Chelan, WA. CERTAIN is a key partner to SCOAP in research and development of new areas for performance surveillance and benchmarking, and the annual retreat was a time for CERTAIN to engage with and update the SCOAP community on current progress and activities in building Washington State’s learning healthcare system. 

The Annual SCOAP Retreat brings together the community to share the successes achieved by SCOAP and its partners in the last year and to hear about new activities and developments that are underway within SCOAP, and through partnership with CERTAIN. Dr. Mike Florence, Chair of the SCOAP Advisory Board, set the tone for the day in describing the importance of the SCOAP and CERTAIN partnership. “The healthcare landscape is changing,” he said. “Surgeons and hospitals are increasingly dependent on each other for survival. What’s more, entities on the more traditional business side of healthcare, such as payers and industry, are looking to take a more active role in healthcare delivery, by increasingly demanding a robust evidence base informed by comparative effectiveness research evaluations before paying for controversial procedures.” Dr. Florence views SCOAP’s partnership with CERTAIN as an innovative step forward in the changing healthcare environment, as CERTAIN is allowing SCOAP and its partners to make use of the large amounts of quality data SCOAP has collected over the years, to inform development of new research and quality activities. 

Dr. Ellen Farrokhi, SCOAP’s Medical Director, confirmed this viewpoint, calling out collaboration with the CERTAIN Learning Healthcare System as a key way that SCOAP will continue to build a community focused on delivering high-quality healthcare and to continue to set the standard for continuous performance surveillance and learning and improving the quality of healthcare. 

Speaking to what CERTAIN brings to the SCOAP and CERTAIN partnership, CERTAIN Medical Director Dr. David Flum said, “There is still a very thin evidence base around what every surgeon should do in caring for his or her patients. What we don’t need is a report card. What we do need is to figure out what is working and how we can share that among our community. We need programs like SCOAP that generate healthcare evidence through quality improvement surveillance, and programs like CERTAIN that partner with SCOAP to provide the learning element to the healthcare system by leveraging data gathered and sharing evidence-based practices back to the community to improve healthcare delivery.” 

CERTAIN meets its goals of providing a learning element to the healthcare system through three main components:

  • A network of Partners in Quality Improvement (QI) and Research that covers the spectrum of care, from SCOAP’s network of 55 hospitals across Washington State providing surgical specialty care, to clinician’s offices providing primary and pre- and post-operative care, to long-term care/skilled nursing facilities, joining together to track quality and benchmark best practices in healthcare delivery.
  • Informed by healthcare data from CERTAIN’s QI and research partners and other sources, as well as input from patients and other stakeholders, CERTAIN investigators lead Evidence Generation activities across clinical disciplines to conduct community-based research and generate a new or refined evidence base.
  • Public health interventions and other activities that move Evidence into Practice through the network of partners in QI and research, and driving continuous healthcare improvement.

CERTAIN’s targets for learning often come from the community with which we collaborate, and Dr. Flum presented several examples undertaken by CERTAIN in the past year, of questions that emerged from the SCOAP and CERTAIN community, were evaluated through the use of SCOAP and other data sources, and translated into information that clinicians can now use to inform the way they treat their patients. For  example, a recently published examination of SCOAP data1 looking at whether or not glucose checks are necessary for non-cardiac surgery indicated that perioperative hyperglycemia is associated with adverse outcomes in patients with and without diabetes, and that the risk of adverse outcomes among patients with hyperglycemia was lowered to levels of patients with normal blood glucose when insulin was administered. This evaluation of SCOAP data answered a valuable question in the healthcare community and can now be communicated back to the SCOAP and CERTAIN community to be implemented into clinical practice.

Hot Topics in CERTAIN Research & Development
Over the upcoming year, CERTAIN will be focusing work in a few key areas, centered on continuing to build up CERTAIN network capabilities and continuing to pursue targets for learning. CERTAIN will continue development in the Patient Voices Project, focused on bringing patients to the table to advise on all aspects of the research process through the Patient Advisory Network, as well as to contribute reports of their outcomes after surgery as a complement to traditional clinical data to inform quality improvement and research activities, and to partner in developing clinical decision-making tools for use by patients and their physicians. CERTAIN will also continue to focus on moving evidence into practice through the Strong for Surgery initiative, which is working to identify and implement evidence-based practices to optimize the health of patients prior to surgery.

1. Kwon S, Thompson R, Dellinger P, Yanez D, Farrohki E, Flum D. Importance of perioperative glycemic control in general surgery: a report from the Surgical Care and Outcomes Assessment Program. Ann Surg. 2013 Jan;257(1):8-14. PMID: 23235393.

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  • CERTAIN Medical Director Dr. David Flum on The Conversation with Ross Reynolds 4/11/12: listen here.