Spine COAP is a physician-led clinical quality improvement collaborative that promotes data-driven quality improvement activities across Washington.

Spine COAP was created based on the structure and principles of the Surgical Care Outcomes Assessment Program’s (SCOAP) surgical surveillance model. Chart abstracted data is entered into an online data management system, which provides risk stratification, registry data entry, auditing, ad hoc and standard performance benchmark reporting to member organizations. The central premise of Spine COAP is that quality of care can best be enhanced through collaborative, not punitive, mechanisms. 

Spine COAP’s unique value includes:

• Data from patient records are systematically abstracted and entered into an online database that meets or exceeds all current federal privacy standards 
• In-depth training and ongoing support of data abstraction staff with rigorous data quality measures that ensure consistent and highly reliable data 
• Real-time reporting for sites on a variety of measures at the provider, hospital or system level with comparison to the aggregate using a variety of population and time parameters; practitioner report cards may also be compared with the hospital or aggregate. 
• Ad-hoc reporting and data tables are available 
• An annual meeting that highlights areas of clinical interest and variation in care and outcomes and sets the stage for quality improvement focus in the coming year 
• A clinician-led management committee that supports and guides the scope of data collection, analyses, research interests, site recruitment and collaboration with other initiatives.

What procedures are included in Spine COAP?

Spine COAP chart abstraction captures clinical information on elective cervical and lumbar procedures on four or fewer spinal levels, with an emphasis on fusion. In addition to procedures, abstraction includes patient demographics, history, risk factors, comorbidities, operative care, perioperative interventions, as well as post-operative events and patient reported outcomes (PROs) through 30 days and six–month intervals for up to five years after the intervention (where possible). Trauma, tumor and infection diagnoses are excluded at this time.  

How many hospitals participate in Spine COAP? 

There are currently seventeen hospitals participating in Spine COAP, representing 70% of the spine surgery done in Washington State. There are 40,000 cases entered into the database to date. 

Who runs Spine COAP?

The Spine Metrics Committee is made up of orthopedic surgeons, neurosurgeons, interventional radiologists and other clinicians. The Metrics Committee reviews the current spine data collection tool to advise on best practices and potential improvements and to develop additional metrics that are needed, participates in the design and development of data-into-practice initiatives and contributes to Spine COAP report design, data review and interpretation. 

How is Spine COAP different from national registries?

Spine COAP is a quality improvement program, not an accreditation mechanism or a data registry. It was developed by and is led by Washington State orthopedic surgeons, neurosurgeons, interventional radiologists and other clinicians.

The National Surgical Quality Improvement Program (NSQIP), the Surgical Care Improvement Project (SCIP), or the Institute for Healthcare Improvement’s 5 Million Lives Campaign collect data from administrative or billing data, or from case sampling from EMRs. Spine COAP program staff provide in-depth training and ongoing support of data abstraction staff with rigorous data quality measures that ensure consistent and highly reliable data.

How does Spine COAP help improve surgical care and outcomes?

Spine COAP participants receive regular reports of hospital level data that provide the information they need to effectively make improvements in care by comparing and tracking their own processes and outcomes: surgeons and hospitals will identify opportunities to improve outcomes and identify unexpected outcomes and can benchmark themselves and organizations to their colleagues and organizations across the state.