The South Carolina Surgical Quality Collaborative (SCSQC) was established in 2015 through funding from the BlueCross BlueShield of South Carolina Foundation. Stakeholders at hospitals across the state collaborated to improve outcomes for those patients undergoing general surgery procedures. Prevention of wound infections, more rapid recovery, better pain control, and lower risk of returning to the hospital are particular areas of focus for the group.
While diabetes is commonly known to lead to complications such as heart disease, strokes, amputations, kidney damage, and blindness, less well known are risks associated with surgery. Not only are people with diabetes more likely to need surgery, they often have multiple underlying diagnoses that can negatively impact surgical outcomes and recovery. In analyzing data, the Collaborative recognized that patients with diabetes have nearly the double the complication rate of patients who do not have diabetes. DFSC is investing in the development of the Surgical Quality Collaborative Diabetes Initiative. The project will engage surgery patients in advance of, during, and after hospital admission to ensure each patient is in the best possible health as it relates to their diabetes at the time of surgery and maintains optimal health throughout recovery.
Four hospitals have committed to participating in the initiative:
- McLeod Health
- MUSC Health
- Piedmont Medical Center
- Regional Medical Center
These facilities will be conducting careful pre-admission evaluation and planning (pre-habilitation) that can greatly mitigate surgical complication risks related to diabetes. They will provide a pre-habilitation service, optimizing blood sugars and addressing the complications of diabetes prior to surgery. Pre-habilitation teams commonly consist of a program lead (nurse practitioner or physician assistant with diabetes experience), surgeon, endocrinologist, and diabetes educator. The teams will have access to specialist support such as cardiology, ophthalmology, psychology, the patient’s existing medical team, and the patient’s social support network. The pre-habilitation will also include an evaluation of educational needs, home and social support systems, and psychological well-being. Patients will be followed by the team not only before surgery, but also during their hospital admission and after discharge.