When Strong for Surgery launched in Washington State almost three years ago, Medical Director, Dr. Tom Varghese Jr., had an ambitious goal: to help every surgical patient become healthier and better prepared for their surgery. His enthusiasm caught the attention of clinicians and healthcare organizations all over the northwest, and the Strong for Surgery program has grown exponentially from our first six pilot sites. As we look forward to the New Year, we reflect back on 2014—a year of growth, impact, and exciting new work:
By the Numbers - 4,000 Patients, 49 Hospitals & Clinics, 200 Surgeons
We attribute our success to our dedicated stakeholders—from surgeon champions and enthusiastic clinicians, to community leaders—we are incredibly grateful for the support we’ve received. Currently, the Strong for Surgery program is active in 49 hospitals and clinics representing at least 200 surgeons. Most importantly, more than 4,000 patients have been screened and optimized using the Strong for Surgery checklists!
Strong for Surgery works to change practice by raising awareness of key factors in pre-surgical care that can improve post-operative outcomes. We are grateful that 2014 brought local and national media attention to the program:
- 10/2014 The Wall Street Journal. "What to Expect When You Have Surgery."
- 9/2014 Physician's Weekly. "Optimizing Patient Health Before Surgery."
- 8/2014 AARP Magazine. "8 Ways to Shape Up for Your Surgery."
- 7/2014 Dr. Edward R. Mariano (Clinical Research)- Blog. “Time to Rethink Preoperative Preparation.”
- 6/2014 Dr. Howard J. Luks -Blog. “Surgical Complications : The Role of Care Before Surgery”
Medical Director, Dr. Tom Varghese Jr., was honored to have the opportunity to present the Strong for Surgery program at more than 40 conferences, meetings, and webinars across the country in 2014. These events provide opportunities to connect directly with clinicians and stakeholders concerned with pre-surgical patient health optimization. Check out a few of our highlights from this year here.
It is well known that smoking is a major cause of surgical complications. Smoking is one of the biggest risk factors in spine surgery—especially in spine fusion, where smokers have a two- to three-times higher chance of fusion failure. The Strong for Surgery smoking checklist offers a convenient way to screen patients for smoking status, and directs them to appropriate cessation resources. Because of this, the Life Sciences Discovery Fund provided funding to support implementation of the S4S program in spine clinics. In 2014, the S4S smoking checklist was implemented in 14 hospitals and clinics around Washington State. To emphasize the importance of patients quitting smoking before their surgery, we engage with audiences about this health issue through social media—especially via Twitter (@Strong4Surgery) where we posted more than 60 smoking-cessation tweets through the year!
The CERTAIN Hub: Improving Data, Improving Care
The CERTAIN Hub is a web-based platform for improved patient data collection and for delivering programs aimed at improving healthcare. It was rolled out to a select number of spine clinics in May 2014; and in July incorporated the Strong for Surgery checklists into electronic surveys given to patients. Through the CERTAIN hub, patients who indicate they are current smokers are automatically directed to free S4S resources to help them quit. In October, Dr. Varghese spoke about the interactivity of the Strong for Surgery patient-facing interface, and reiterated the value of a multi-pronged approach to ending smoking amongst spine surgery patients. His presentation also featured preliminary data from Spine SCOAP that showed improvements in smoking rates over the course of the Strong for Surgery program.
Perioperative Glucose Control Best Practices
One-in-four surgical patients experiences hyperglycemia during their hospital stay, which is strongly associated with surgical site infections and other complications. That is why Strong for Surgery teamed up with the Washington State Hospital Association (WSHA) and Qualis Health to review current surgical glucose control practices and evidence-based research on successful implementation of perioperative glucose control. Draft guidelines developed by the collaborative were presented at the April 23rd Partnership for Patients Safe Table “Reducing Surgical Site Infections in the Perioperative Period.” Learn more and review a draft of these guidelines here.
Opioid Minimization Pilot Project
Undertreated pain, opioid related adverse events, and prescription opioid abuse remain important public health problems. Strategies for helping patients to achieve pain relief and also minimize their use of opioids are needed now more than ever. In 2014 Strong for Surgery began an exploratory opioid minimization pilot project with the goal of educating patients about alternatives to opioids for pain management in a core group of pilot sites. An active group of healthcare stakeholders is working together to design, develop, and test a comprehensive opioid minimization strategy.
Looking ahead: Mobile Strong for Surgery
Until now, the Strong for Surgery implementation process has involved hands-on support from our implementation staff and considerable effort by clinic staff to adapt workflow. As the program evolves and expands, we recognize the need for a more scalable implementation model. To that end, in 2015 we will begin developing a mobile platform aimed at improving the S4S checklists and screening process, while reducing the burden of day-to-day program management by clinicians and their staff. Mobile Strong for Surgery will complement the traditional S4S program by electronically assessing patient risk factors, delivering interactive risk reports to patients and clinicians, providing educational programming, and prompting risk-reduction behaviors prior to surgery.
Wishing You a Safe and Healthy New Year!
We have much to look forward to in the New Year and we hope to continue sharing our success with you. Stay up-to-date with Strong for Surgery by following us on Twitter, liking us on Facebook, and reading our blog. On behalf of the Strong for Surgery team, we wish you a safe and healthy 2015!