Spine COAP Overview

What is Spine COAP?

  • Spine COAP is a surgeon-led collaborative that uses performance surveillance and benchmarking to help deliver more appropriate, safer and higher quality surgical spine care across Washington State.
  • Spine surgeons engaged in the process of selecting evidence-based QI metrics for monitoring -aligned to emerging national metrics when available – also including  a set of “common sense” metrics and those with emerging evidence
  • A community of surgeons acting on performance data through education, peer-benchmarking effects, and interventions

What types of data are in Spine COAP?

  • Data include patient risk, process of care and adjusted outcomes for up to 5 years after discharge. Check out the latest Spine COAP report.
  • Data are extracted from increasingly automated clinical records by trained hospital staff using a transparent data dictionary and audited to ensure accuracy
  • Outside of Spine COAP, other SCOAP modules exist for colorectal surgery, appendectomy, bariatric surgery, pediatric surgery, and small bowel obstruction due to postoperative adhesions (both surgically and medically managed).

How does Spine COAP work?

  • Spine COAP reports benchmark hospital performance against the Spine SCOAP community of hospitals
  • Quarterly “signal” (red, yellow and green) indicates underperformance opportunities
  • Spine COAP helps hospitals improve areas of underperformance by sharing best practices developed in the network.  This includes educational events, standardized order sets, community meetings (both virtual and in-person) and quarterly newsletters addressing emerging evidence and engaging community debate Spine SCOAP creates a healthcare system built on collaboration, benchmarking and education

How is a Spine COAP report valuable?

  • Spine COAP reports focus on both process of care and risk-adjusted outcome.
  • QI programs that only focus on outcome outliers assume the care that was received in cases with adequate outcomes was correct. With Spine COAP, even if risk adjusted outcomes are not in the “outlier” category the reports are valuable and show opportunities for QI.  The use of evidence based process of care measures should be 100%.  These measures represent actionable steps that can be taken to improve care in the very next case a surgeon does Spine COAP reports engage surgeons in their data by showing them how they compare to colleagues and by giving them action items to improve the care they deliver
  • Administrative details
    Who runs Spine SCOAP?

    • Spine COAP is a program of the Foundation of Healthcare Quality.
    • A surgeon-led management committee gives strategic direction to Spine COAP.  The Spine COAP Metrics/Data Team functions as a subcommittee of the management committee and provides opportunities to provide feedback and participate in the ongoing development of the Spine COAP module.

    Are the data protected?

    • Spine COAP, as one of FHCQ’s clinical quality programs, is designated a Coordinated Quality Improvement Program (CQIP) that protects the data from discovery – much like M&M conferences.
    • Your hospital owns their data, Spine COAP data is not shared in any identifiable way without the hospital’s permission.

    What is the scope of Spine SCOAP?

    • Spine COAP is currently used in 18 hospitals in Washington State representing over 70% of the state’s inpatient surgical care

    How do you join Spine COAP?

    • Hospitals interested in joining can contact the SCOAP/Spine COAP Program Director at the Foundation for Healthcare Quality, by emailing vkolios@qualityhealth.org.