The third featured speaker of this year's Harvard Surgical HSR Speaker Series event is Shawn Rangel, MD, MSCE. His presentation is entitled, "The past, present & future of Pediatric NSQIP: Evolution from a safety registry to comprehensive comparative performance platform."
Dr. Rangel is an Associate in Surgery at Boston Children’s Hospital (BCH). An integral part of his clinical effort is teaching pediatric surgical care to fellows and residents from the Harvard-affiliated hospitals, Lahey Clinic, St. Elizabeth’s Medical Center, and Boston Medical Center. he also provides one-on-one mentorship to medical students during their pediatric surgery rotation, delivers core curriculum lectures to medical students and surgical trainees, and contributes to the core curriculum for BCH pediatric residents and neonatology fellows. In addition to his local teaching efforts, he has also established a national reputation for mentorship surrounding the use of surgical safety checklists after leading a consortium of 15 children’s hospitals in a national implementation campaign. This work has garnered awards and accolades from several organizations.
At BCH, his research efforts have focused on characterizing variation in practice, resource utilization and outcomes for high-volume pediatric surgical conditions with an emphasis on pediatric appendicitis. Practical applications of this work have included the development of novel, value-based comparative performance benchmarks for the prioritization of QI efforts at the level of individual hospitals, and as a means to set national priorities for collaborative QI efforts. Specifically, the benchmarks were used by the CHA to develop the first automated and risk-adjusted comparative performance report card for its 44 member children’s hospitals, and formed the basis for a multi-center & multi-disciplinary appendicitis QI collaborative with the goals of reducing practice variation and promoting value–based care.
Using the CHA appendicitis report card and collaborative as a model, he had the opportunity to subsequently lead the development and implementation of the first disease-specific, comparative-performance module for the American College of Surgeon’s Pediatric National Quality Improvement Program (ACS NSQIP-P). As chair of NSQIP-P’s Measurement & Evaluations Committee, he led a charge by the ACS to develop a similar portfolio of disease-specific comparative performance modules using the appendicitis experience as a conceptual framework. He has lectured broadly on the methods and implications of comparative performance measurement for driving collaborative quality improvement, including at meetings of the American College of Surgeons, American Pediatric Surgical Association, American Academy of Pediatrics, Canadian Association of Pediatric Surgeons, and the Children’s Hospital Association, among others.