2025 Quality and Safety Conference Points to Bold Future of Surgical Quality

Members of the surgical quality improvement (QI) community are advancing the field in unprecedented ways. That was a key takeaway from the recent 2025 ACS Quality and Safety Conference (QSC), which took place July 17–20 in San Diego, California, with the theme “Embracing Change and the Future of Quality.”

Approximately 1,500 surgeons and other QI professionals attended the event, which celebrated the 20th anniversary of a meeting that began when the ACS adopted and expanded the National Surgical Quality Improvement Program (NSQIP) from the Veterans Administration.

“ACS NSQIP has changed the very culture of our surgical profession, and in doing so, all of us have improved the lives of millions of surgical patients,” said Bruce L. Hall, MD, FACS, from the University of California Davis Health in Sacramento, and Program Director for QSC.

Building on that history, Clifford Y. Ko, MD, MS, MSHS, FACS, Senior Vice President of the ACS Division of Research and Optimal Patient Care, discussed the significant step forward that is taking place with the new ACS clinical data strategy, which he announced in his opening remarks. 

The ACS has entered into an agreement with Epic Systems, the largest electronic health records (EHR) provider in the US. This agreement is part of a multiyear strategy that will involve several technology companies and will lead to the development of innovative solutions and tools to enhance how data are used and accelerate the QI process. 

“This strategy will make data collection less burdensome, less expensive, more efficient, broader, and simultaneously more detailed,” Dr. Ko said.

Throughout the conference’s General Sessions, speakers described current efforts to advance technology, methodology, and teamwork to bolster surgical QI.

HIT and Project Planning Drive the Future of Quality

The ACS data strategy is designed to decrease friction in the process of transmitting actionable data to researchers and those on the front line of patient care, and a major part of that efficient future will require the continuing evolution of health information technology (HIT).

“Clinical registries are foundational to our quality efforts, but they have room to improve. Human-intensive abstraction is retrospective and slow to adapt,” said ACS Chief Health Informatics Officer Genevieve Melton-Meaux, MD, PhD, FACS, from the University of Minnesota in Minneapolis.

She added that evolving data procurement platforms will include additional automation and injection of artificial intelligence (AI) into the data abstraction process to streamline usable data.

While the ACS data strategy speaks to a high-level vision for how technology and collaborations will advance quality surgical care, “small-scale, frontline QI—the kind performed by surgeons, nurses, registrars, quality officers, which the team actually touches and that patients experience—is essential,” Dr. Ko said.

To that end, the ACS collaborated with The Healthcare Improvement Studies Institute to develop the Early Planning of Small-Scale Surgical Improvement Projects (EPoSSI) Tool, which focuses on the critical early stages of project planning that lay the groundwork for success. The tools cover nine domains such as choosing an improvement team, developing aims, planning intervention implementation, and deciding on “go/no go,” among others.

“Small-scale efforts aren’t often published, and we don’t often know a lot about them—and yet, this is where frontline care happens. If we do these small-scale efforts better, a lot of care will get better for our patients” in a much shorter timeframe, Dr. Ko said.

AI Synopses of Operative Data Could Advance Training

As much as technology is changing QI and high-level decision-making, new developments may have an impact on training and care within the OR itself.

During a session on the future of surgery, Carla Pugh, MD, PhD, FACS, from Stanford University School of Medicine in California, spoke on how multimodal data capture is providing a level of personalized intraoperative feedback that could change how surgeons and trainees understand their strengths and weaknesses. The baseline starts with surgical video.

“The real benefit of AI is related to automated analytics. It can help find and deliver that short, 5–10 second video clip to review from a 4-hour procedure, which by itself saves considerable time and effort,” she said. From there, audio capture, electroencephalogram, and motion capture work in tandem with the video to provide a window into a surgeon’s or trainee’s activities.

As an example, Dr. Pugh shared data from hand sensors during a macrovascular anastomosis. A side-by-side comparison showed a faculty surgeon operates with considerably greater efficiency, smoothness, and velocity than a trainee.

Nassib Chamoun, founder, president, and CEO of Health Data Analytics Institute also addressed current and near-future uses of AI within surgical care workflows.

He noted that AI could save a significant amount of clinician time managing patient information in the EHR by proactively designing the right patient workflow, aligning resources to needs, and delivering actionable insights at the point of care.

Chamoun described how his team has used AI to build hundreds of predictive models based on Medicare data for outcomes, utilization, and cost to understand performance at a granular level, with the next steps in development.

“You need to have a real-time platform that can process all these data and deliver the information not just to clinicians, but to every member of the care team on the front line,” Chamoun said, adding that generative AI agents are uniquely suited to this stratified aggregation and are able to deliver information that is fully transparent and traceable.