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Members of the 555th Forward Surgical Team rush a simulated trauma patient to surgery during training with the Strategic Trauma Readiness Center of San Antonio (STaRC) at Brooke Army Medical Center, Fort Sam Houston, Texas. (Photo by Jason Edwards, Brooke Army Medical Center.)

Members of the 555th Forward Surgical Team rush a simulated trauma patient to surgery during training with the Strategic Trauma Readiness Center of San Antonio (STaRC) at Brooke Army Medical Center, Fort Sam Houston, Texas. (Photo by Jason Edwards, Brooke Army Medical Center.) ()

The American College of Surgeons National Surgical Quality Improvement Program has recognized Brooke Army Medical Center (BAMC) for meritorious outcomes for surgical patient care for the second year in a row, ranking the hospital among the top 10% of participating hospitals for surgical care.

“Earning meritorious recognition two years in a row shows the BAMC and SAMHS (San Antonio Military Health System) team’s ongoing commitment and dedication to continuous improvement and quality care,” said Air Force Col. Patrick Osborn, surgeon-in-chief, SAMHS, and BAMC deputy commander for surgical services.

BAMC, located on Joint Base San Antonio-Ft. Sam Houston in San Antonio, Texas, is one of 89 ACS NSQIP participating hospitals in the United States that have achieved meritorious recognition for surgical patient care. Additionally, NSQIP recognized 72 hospitals on its “All Cases” list and 72 hospitals on its “High Risk” list. BAMC was the only military treatment facility, and one of only 50 hospitals nationwide, recognized on both lists.

“BAMC provides more complex care to the nation than any other military treatment facility and the recognition of excellence for ‘All Cases’ and ‘High-Risk’ categories is a testament to the unique expertise and skill of our entire staff,” Osborn said.

“We are honored to be recognized by the American College of Surgeons for our hospital’s performance,” said Air Force Maj. Robert Krell, NSQIP surgeon champion and surgical oncologist. “This achievement reflects the hard work of hundreds of BAMC’s technicians, nurses, physicians and leaders, and shows our patients that their surgical care at BAMC is among the highest quality in the nation.”

Achieving meritorious recognition means that BAMC ranks in the top 10% of over 719 hospitals on a composite surgical quality score.

“This is a significant accomplishment,” said Army Brig. Gen. Shan Bagby, BAMC’s commanding general. “It is a testament to the commitment our entire staff has to provide safe, quality care for our patients each and every day.”

Osborn agreed. “The efforts of all, including front desk staff, housekeeping, nutrition, technicians, nursing, rehabilitation specialists and our phenomenal physicians and surgeons, are truly awesome to observe every day, and I am elated that their efforts are highlighted by this award,” he said. “From the time a patient presents to the emergency department or clinic through their surgery on to mobilization and functional rehabilitation, our patients, beneficiary and civilian, receive the best care the DOD offers. That translates directly to improved care on the battlefield and lives saved.”

As a participant in ACS NSQIP, BAMC is required to track the outcomes of all surgical procedures and collect data that directs patient safety and the quality of surgical care improvements.

The ACS NSQIP recognition program commends a select group of hospitals for achieving a meritorious composite score in either the “All Cases” category or a category which includes only “High Risk” cases. Risk-adjusted data from the July 2020 ACS NSQIP Semiannual Report, which presents data from the 2019 calendar year, was used to determine which hospitals demonstrated meritorious outcomes.

Each composite score was determined through a different weighted formula combining eight outcomes. The outcome performances related to patient management were in the following clinical areas: mortality, unplanned intubation, prolonged ventilator use, renal failure, cardiac incidents including cardiac arrest and myocardial infarction; respiratory illness such as pneumonia; surgical site infections-superficial and deep incisional and organ-space; or urinary tract infection.

ACS NSQIP is the only nationally validated quality improvement program that measures and enhances the care of surgical patients. This program measures the actual surgical results 30 days postoperatively as well as risk adjusts patient characteristics to compensate for differences among patient populations and acuity levels.

The goal of ACS NSQIP is to reduce surgical morbidity, which is infection or illness related to a surgical procedure, and surgical mortality, which is death related to a surgical procedure, and to provide a firm foundation for surgeons to apply what is known as the “best scientific evidence” to the practice of surgery.

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