ASO Author Reflections: Unplanned Return to the Operating Room: Implementing a Specialty-Specific NSQIP in Patients Undergoing Head and Neck Surgery with Free Flap Reconstruction

Excerpt

Head and neck surgery with free flap reconstruction represents some of the most complex patients to manage perioperatively. While outcomes in these patients have been improving, they continue to present opportunities for growth. Unplanned return to the operating room has been used as an objective measure of perioperative morbidity when mortality is low, such as in head and neck surgery reconstruction cases. Furthermore, unplanned return to the operating room is a major cost driver. In an era of cost containment, reducing unplanned interventions can reduce cost of care. While predicting risk and outcomes in patients undergoing general and vascular surgery has been successful with the American College of Surgeons National Surgical Quality Improvement Program (NSQIP), the limitations of this program in other surgical subspecialties is recognized by the American College of Surgeons.1^–3 We therefore used a novel specialty specific Head and Neck–Reconstructive Surgery NSQIP to investigate risk factors for unplanned return to the operating room.4 …