Since the early 1990s, Veterans Affairs (VA) has been at the vanguard of national efforts to measure hospital-level performance and ensure quality care for veterans. In response to a congressional mandate that “the VA should report its surgical outcomes in comparison to the national average…with risk adjustment,” the initial VA National Surgical Quality Improvement Program (NSQIP) was created to accurately collect clinical data using standardized methodology and incorporating robust risk adjustment.¹ Renamed the VA Surgical Quality Improvement Program (VASQIP) after merging the cardiac and noncardiac surgery components of NSQIP, this mandatory, VA-wide program has remained a model for national quality improvement (QI) efforts and was the template used to develop the private sector American College of Surgeons–NSQIP.

自1990年代初以来，退伍军人事务（VA）一直是衡量医院水平绩效并确保为退伍军人提供优质护理的国家努力的先锋。为了响应国会的一项授权，即“弗吉尼亚州应报告其手术结果与全国平均水平的比较……并进行风险调整”，最初的弗吉尼亚州国家外科手术质量改进计划（NSQIP）的创建是为了使用标准化方法准确地收集临床数据并纳入强大的风险调整。^1个 合并了NSQIP的心脏和非心脏手术组成部分后，VA外科手术质量改善计划（VASQIP）改名为VA外科手术质量改善计划（VASQIP），该计划一直是国家质量改善（QI）努力的典范，并且是发展私营部门的模板美国外科医生学院-NSQIP。