Project objectives

The aim of the project was to compare data collected by Surgical Clinical Reviewers (SCRs) for submission to the National Surgical Quality Improvement Program (NSQIP) with data collected by hospitals as a by-product of administrative processes (i.e. data contained in hospital patient administration systems). The project was undertaken in the context of the expansion of hospitals in NSW participating in NSQIP, to reduce the effort by SCRs to enable them to achieve the sample sizes of data requested by the Program, and to maximise the quality of the data.

NSW Agency for Clinical Innovation

Our approach

HPA listed out the NSQIP data variables and compared them with the variables available in the administrative data, looking at the potential to construct the NSQIP variables from administrative data ensuring adherence to NSQIP definitions and quality of the data. The analysis drew on knowledge about administrative data, and particularly, coding in the International Classification of Diseases – 10th Revision – Australian Modification (ICD-10-AM) and including the Australian Classification of Healthcare Interventions (ACHI) and American coding systems such as Current Procedural Terminology (CPT).

HPA also observed the processes undertaken by the SCR at Westmead Hospital to identify opportunities to streamline the work of the SCR, and to investigate the reasons for differences for data elements that were expected to be comparable between the administrative data and NSQIP data.

Finally, HPA used the administrative data to predict death, surgery-related post-operative complications and surgery-related hospital readmissions. This was compared with the predictive capabilities of NSQIP. This was done to critically evaluate the need for the wide range of variables required by NSQIP.


The project identified opportunities for greater automation of the data required for NSQIP using data routinely collected by hospitals for administrative purposes. It also made recommendations on improvements to hospital data processes that will benefit both SCRs and hospital staff compiling the administrative data. These included improving systems to capture clinical data, such as more widespread use of electronic medical records, and structuring information in these systems to enable easier extraction and analysis. Finally, it also made recommendations on developing SCRs as a new workforce in Australia.

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