Evidence-based outcome data after hernia surgery: A possible role for the National Surgical Quality Improvement Program

Since its inception in 1994, the National Surgical Quality Improvement Program (NSQIP) has been used to compare the performance of all Veterans Administration (VA) hospitals offering major surgical procedures. The program’s outcome data are used to identify areas of both excellent and poor performance. The data can also be used to focus on specific procedures, especially high frequency operations such as inguinal herniorrhaphy. Following several successful feasibility studies, the NSQIP has been adopted by the American College of Surgeons (ACS) and is being offered nationwide in the non-VA sector. Given the profound decrease in operative mortality and morbidity seen within the VA, it seems realistic to expect similar improvements in global—and procedure specific—surgical outcomes within the non-VA sector.