Our Accomplishments

Establishing the South Carolina Surgical Quality Collaborative With the Help of The BlueCross BlueShield of South Carolina Foundation


Patients who undergo surgery expect a positive outcome with the least risk of complications possible. Each year, however, complications occur in as many as 17 percent of all surgeries performed in the United States. The question is what more can be done to ensure the best possible outcomes for all patients.

In 2015, the BlueCross BlueShield of South Carolina Foundation awarded a $3.8 million, three year grant to Health Sciences South Carolina (HSSC) to establish the South Carolina Surgical Quality Collaborative to improve surgical safety and provide the highest value surgical care to the citizens of the state.

“We’re funding this unprecedented initiative to help ensure patients undergoing surgery for the 15 most common surgical procedures have the highest quality outcome possible,” said Harvey Galloway, executive director of the BlueCross BlueShield of South Carolina Foundation. “The project also creates a level playing field for the one-third of South Carolinians who are underinsured or uninsured. Economically disadvantaged patients in South Carolina suffer post-surgical complications at a higher rate due to a higher prevalence of chronic disease and lack of health care access, among other factors,” Galloway said. “We view the South Carolina Surgical Quality Collaborative as a critical opportunity to reduce health disparities in our state by reducing surgical morbidity and mortality rates in a culturally sensitive manner. The success of this initiative will save lives and improve the quality of life for all South Carolinians.”

The project’s lead organizations are HSSC and the South Carolina Hospital Association (SCHA). It also leverages the strengths of the South Carolina Chapter of the American College of Surgeons and the Medical University of South Carolina (MUSC) Department of Surgery. At the conclusion of the three-year project, the South Carolina Surgical Quality Collaborative is targeting a three percent reduction in surgical complications, 5,500 avoided hospital days, and more than $25 million in savings. The Collaborative’s approach will be used to train the state’s next generation of surgeons who are completing surgical residency programs throughout South Carolina.

Health care and surgical leaders at MUSC, the University of South Carolina (USC), HSSC, SCHA, and participating hospitals will study the 15 most common general, vascular and gastrointestinal surgical procedures, such as gallbladder surgery or colon surgery, using near-real time data from participating hospitals. These data will provide an opportunity to benchmark surgical outcomes statewide, and allow for approaches to improving surgical quality and patient safety that makes sense for specific health systems and communities. The South Carolina Surgical Quality Collaborative resembles similar programs implemented in Michigan and Tennessee, which have succeeded in reducing overall surgical complications and wound disruption by more than one-third. However, the South Carolina initiative is unique as it establishes a patient engagement group to address patient-level factors outside of clinical procedures that may influence surgical outcomes. David J. Cole, M.D., FACS, as both MUSC’s president and a practicing surgeon, sees the need to develop such grassroots initiatives that can change traditional relationships and provide tangible opportunity for better patient care.

“By creating the opportunity for surgeons and hospitals to come together and have frank, open and productive conversations about how to improve surgical outcomes for South Carolinians, this collaborative will move the needle on improving surgical safety and quality. An important first step is engaging physicians and providing them a safe zone to give feedback. An equally important second step is working with real-time validated outcomes data to improve our performance and patient care. Right now, first generation quality initiatives use retrospective data that can be at least six months old and do not garner the strength of collective impact. This creates inherent problems in effectively dealing with acute procedural and quality issues, or identifying what best practices might look like. I’m excited to see this collaborative grow, and am grateful to have the dedication of the BlueCross BlueShield of South Carolina Foundation, HSSC, and SCHA as our partners in the work ahead,” Cole said.

Other powerful implications of the study involve how the South Carolina Surgical Quality Collaborative leverages its findings. HSSC Chief Medical Officer Christine Turley, MD, is the project principal investigator and will work closely with SCHA to bring new, evidence-based surgical quality improvement programs to eight major acute care hospitals in the state. She said that the new quality improvement techniques and data evaluation protocols will be integrated into surgical residency programs, ensuring these principles impact current and future surgical teams.

“The surgical quality program in South Carolina is unique nationally for its approach to engaging patients in order to broaden medicine’s understanding of patient-level factors and post-surgical outcomes and complications. HSSC is pleased to participate in a critical initiative that convenes research universities, health systems, insurers, and medical schools to solve immediate and long-term health problems. This collaboration has the power to transform surgical care for all South Carolinians, regardless of background and health insurance status,” Turley said.

SCHA CEO and President Thornton Kirby added that the state’s hospitals are grateful to the BlueCross BlueShield of South Carolina Foundation for recognizing the significant potential of the South Carolina Surgical Quality Collaborative to improve surgical quality and safety for generations to come. “Because of the foundation’s generosity and commitment to improving health, SCHA, HSSC, MUSC, and other collaborators have a unique opportunity to transform general surgical care for all South Carolinians. By targeting high volume and high-risk general surgical procedures, we expect to reduce surgical complications and save many lives. That is a worthy aim for all of us to shoot for together,” Kirby said