THA Headlines and Resources

Tennessee Surgical Quality Collaborative Saves 533 Lives and $75 Million in Three Years

NEW YORK, NY (July 28, 2:45 pm ET): Ten hospitals in the Tennessee Surgical Quality Collaborative (TSQC) have reduced surgical complications by 19.7 percent since 2009, resulting in at least 533 lives saved and $75.2 million in reduced costs, according to new results presented today at the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) National Conference in New York City.

The hospital collaborative was formed in 2008 as a partnership of the Tennessee Chapter of the American College of Surgeons and the Tennessee Hospital Association’s (THA) Center for Patient Safety, with support from Blue Cross Blue Shield’s Tennessee Health Foundation. Through the ACS NSQIP program, TSQC hospitals collected clinical, 30-day outcomes data from 10 participating hospitals to examine and identify trends in and evaluate best practices. Between 2009 and 2012, participating hospitals collected data on more than 55,000 surgical procedures and researchers examined rates of 17 different types of surgical complications.

Compared with complication rates in 2009, participating hospitals in 2012 achieved 19.7 percent fewer postoperative occurrences (p<0.001), and the postoperative mortality rate dropped 31.5 percent (p<0.001). Hospitals prevented an estimated 3.75 deaths per 1,000 surgical procedures and avoided $75.2 million in excess costs. The collaborative saw improvements in 13 of the 17 types of complications, and nine improved significantly (p<.05). The areas of most improvement included all types of surgical site infections, pneumonia and urinary tract infections, which all dropped by approximately one-third.

“Our results show not only have Tennessee hospitals improved care, but we’ve been able to sustain those improvements over time,” said Brian Daley, MD, MBA, FACS, lead author of the study and professor of surgery and chief of the division of trauma and critical care at the University of Tennessee Medical Center, Knoxville. “Our collaborative approach and use of robust clinical outcomes data through ACS NSQIP is an effective model for quality improvement across our state and nationally.”

An earlier study based on TSQC data was published in the Journal of the American College of Surgeons in 2012; it showed the 10 TSQC members reduced complication rates and saved more than $8 million in excess costs from 2009 to 2010. This new study shows TSQC hospitals continued to improve in the years after the program was launched. In 2012, the collaborative expanded and now includes 22 Tennessee hospitals.

“Participation in an ACS NSQIP collaborative is helping Tennessee hospitals accelerate their improvements by sharing data, comparing results, and evaluating best practices among peers,” said Oscar Guillamondegui, MD, MPH, FACS, chair of TSQC’s leadership committee and an associate professor of surgery and director of the Vanderbilt multidisciplinary traumatic brain injury clinic at Vanderbilt University Medical Center.

“The TSQC has helped align the efforts of hospitals and surgeons around quality improvement, which supports the THA board's commitment toward zero incidents of preventable harm in our state's hospitals,” stated Craig A. Becker, THA president. “This collaborative is an excellent example of how the hospital association, physicians, hospitals and payers can work together to improve care using clinically valid measures in a cooperative way.”

ACS NSQIP is the leading nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care in hospitals. The program provides a prospective, peer-controlled, validated database of pre-operative to 30-day surgical outcomes based on clinical data, not claims data.


Other study authors include Joseph B. Cofer, MD, FACS; William C. Gibson, MD, FACS: Scott A. Copeland, MD, FACS; Chris Clarke, RN; William Cecil, MBA; and Barbara J. Martin, RN, MBA, CCRN.

Cindy Siler Named 2014 Outstanding Network Leader

Cindy Siler, deputy director, Tennessee Rural Partnership, recently received the outstanding network leader of the year award from the National Cooperative of Health Networks (NCHN). The award recognizes a network leader for leadership in managing a successful health network organization.

Siler was recognized for:

  • Providing outstanding leadership;
  • Involvement with the network members;
  • Long-term sustainability of the network;
  • Active participation in the network’s service community; and
  • Lasting contributions to the overall health care system of the area.

Karen Utley Honored With THA Small or Rural Hospital Leadership Award

Karen Utley, vice president of system services, West Tennessee Healthcare, Jackson,was presented with the 2013 THA small or rural hospital leadership award in recognition of her service to rural healthcare in Tennessee at the association’s recent small or rural hospital conference.

Photo of Karen Utley and THA President Craig Becker

Karen Utley and THA President Craig Becker

Utley has served as the chair of the Future of Rural Hospitals Task Force, which has developed a set of specific actionable strategies to best position Tennessee rural hospitals for financial sustainability. She also serves on the Tennessee Rural Partnership board of directors and previously served as the west Tennessee district representative on the THA board of directors. She has been a major advocate for rural health issues in Tennessee and a tremendous asset for THA.

65 Hospitals Recognized for Leadership in Improving Infant Health

Sixty-five hospitals are being recognized by the Tennessee Hospital Association’s (THA) Tennessee Center for Patient Safety for their leadership in reducing the number of babies born electively between 37 to 39 weeks. There is a greater risk of complications associated with births prior to 39 weeks, and waiting until 39 weeks allows for better growth and development of vital organs such as the brain, lungs and liver. 

These hospitals successfully met their goals of decreasing the number of babies delivered electively between 37 to 39 weeks gestation to 5 percent or less and have maintained this goal for a minimum of six consecutive months. This dramatically increases the chances for good physical and developmental health of babies. It also allows for better health and safety of the mother. The hospitals are being awarded congratulatory banners to recognize their teams’ outstanding efforts by the Tennessee Center for Patient Safety.

“Babies born too early are at risk for respiratory distress, jaundice, hypoglycemia and other conditions that require more medical care and put them at greater risk for death before their first birthday,” said Craig A. Becker, THA president. “That is why the work being done at these hospitals is so vitally important to all Tennesseans. Results like these represent the combined efforts of every single professional at the hospital, from the physicians and nursing staff to the board of trustees.”

The hospitals are part of a statewide Healthy Tennessee Babies Are Worth the Wait initiative launched less than two years ago to increase awareness of the benefits of full-term delivery. In May 2012, nearly 16 percent of all Tennessee deliveries that occurred prior to 39 weeks gestation were considered elective. Today, the number of early elective deliveries has been reduced by almost 85 percent.

Among other activities, these hospitals adopted a strict hard-stop policy that prohibits early elective deliveries before 39 weeks unless there is a clear medical risk to the mother or the baby.

The Healthy Tennessee Babies Are Worth the Wait program is a partnership among local hospitals, the Tennessee Department of Health, THA, Tennessee Initiative for Perinatal Quality Care, March of Dimes and Tennessee Center for Patient Safety. The coalition has been recognized nationally as an example of successful collaboration in patient safety. For more information about the Healthy Tennessee Babies Are Worth the Wait program, go to

THA’s 2013 Diversity and Inclusion Report Released

The THA Council on Diversity (now known as the THA Council on Inclusion and Health Equity) has released its 2013 report. An update on the continuing work of the Disparities Solutions Project (DSP), results from the 2013 diversity survey and a recap of last summer’s Agenda 21 program are included in the report.

THA 2013 Report on Diversity and Inclusion

Tennessee Hospitals Support Safe Sleep Project

Photo of Craig BeckerTHA President Craig Becker participated in the Tennessee Department of Health’s (TDH) recent launch of its safe sleep education and book project, which is designed to reduce sleep-related deaths in infants. While the department began its initial campaign in 2012, TDH launched the book project last week in partnership with the Charlie’s Kids Foundation and Tennessee hospitals. TDH will provide hospitals with copies of the Sleep Baby Safe and Snug board book for each baby born in their facilities in 2014. Hospitals are implementing safe sleep policies in their organizations to train staff and ensure staff model the correct behaviors for new parents, in addition to giving out the books for each new baby. All THA member hospitals have pledged to participate in the program and Tennessee is the first state to use the books in a statewide campaign through hospitals. For additional information about the safe sleep program, go to

THA HEN Receives Additional Year Award

The THA hospital engagement network (HEN) has been awarded a third contract year from CMS’ Innovation Center to continue the work of reducing hospital-acquired conditions by 40 percent and preventable readmissions by 20 percent. The funding will help support the improvement efforts and bring new resources to the 65 hospitals in the THA HEN.

An overview webinar will be held on January 8 at 10:00 CT for THA HEN hospitals, describing the 2014 program and expectations. Those hospitals that do not belong to a HEN also are encouraged to attend and are welcome to join the THA HEN.

To register for the webinar, go to questions or more information, contact Patrice Mayo at THA,, 615-401-7434.

All Tennessee Birthing Hospitals Pledge to Wait for Babies to Arrive

One hundred percent of the hospitals that deliver babies in Tennessee have agreed “a healthy baby is worth the wait” and have signed pledges to implement “hard stop” policies to reduce early elective deliveries. The Tennessee Department of Health has partnered with THA, the Tennessee Initiative for Perinatal Quality Care and March of Dimes to reduce early elective deliveries in Tennessee, since shortening the time a baby develops in the womb can create a range of serious health problems.

Thanks to combined efforts by hospitals, clinicians and health leaders, the number of early elective deliveries is decreasing in Tennessee. In May 2012, nearly 18 percent of deliveries before 39 weeks in Tennessee were considered elective. Just 16 months later, the percentage is consistently below four. 

The Healthy Babies are Worth the Wait initiative targets expectant and prospective parents, healthcare providers and healthcare facilities to educate them about the benefits of waiting until at least 39 weeks for delivery of babies. Learn more about the initiative and what you can do to reduce premature births at

For additional information about the initiative, contact Chris Clarke at THA, 615-256-8240,