SCOAP Comparative Effectiveness Research Translation Network


To expand and leverage datasets on quality of surgical care and collect patient outcomes, which will allow the health-care system to dynamically “learn” from patient care

Anticipated Impact: 

Increased use of health-care best practices, resulting in improved patient outcomes and reduced health-care expenditures


The Surgical Care and Outcomes Assessment Program (SCOAP), funded in part by a 2007 LSDF grant to David Flum at the University of Washington, collects and shares data on surgical procedures and patient outcomes among hospitals statewide to promote widespread use of the safest and most effective practices. SCOAP serves as a platform for comparative effectiveness research (CER), the science of understanding how well health-care interventions work and how different health-care strategies impact patients and the health-care system. Integrating CER into health-care decision-making will likely be critical for getting more value out of health-care dollars. CERTN links SCOAP data to records from outpatient facilities, statewide payer health-care and claims data, the state's vital status registry, and patient-reported outcomes surveys to provide investigators, insurers, health-care stakeholders, and policymakers with longitudinal data on surgical and medical treatment and patient outcomes to ultimately improve best practices and cost-effectiveness. CERTN is analogous to the aviation safety system, in which problems and errors are quickly reported and acted on to improve safety. CERTN will serve as a model for other communities that are trying to develop a learning health-care system.

A supplement was awarded to extend the program to pre-hospital care, i.e., in clinicians’ offices, to optimize patient health prior to surgical intervention. A pilot to eliminate smoking in patients prior to spine fusion is expected to reduce re-operations necessary for failed spine surgery, saving an estimated $8 million annually in Washington. A business plan to create and market SCOAP/CERTN services will also be developed and implemented.

Collaborating Organizations: Aetna, ARMUS, CIGNA, Foundation for Health Care Quality, Fred Hutchinson Cancer Research Center, Inland Northwest Health Services, Microsoft, Premera Blue Cross, Regence, Spokane Community Clinical Data Repository, Washington Department of Social and Health Services/Medicaid, Washington State Health Care Authority, Washington State University

See also:

Comparative Effectiveness Research

Grant Update

Principal Investigator:
David Flum
Grantee Organization:
University of Washington
Grant Title:
SCOAP Comparative Effectiveness Research Translation Network
Grant Cohort and Year:
2010 Program Grant (02)
Grant Period:
10/16/2011 - 10/15/2015 (Completed)
Grant Amount:
CERTAIN is Washington State’s learning healthcare system, focused on evaluating the effectiveness and value of healthcare and keeping the patient’s voice central, seeking to improve quality of care through actionable research. Supported by LSDF funding, CERTAIN has grown to encompass a network of up to 50 hospitals and doctor’s offices, as well as skilled nursing facilities and conducted 25 research and quality improvement projects in the last five years Forums, advisory groups, and partnerships allow stakeholders in healthcare (patients, providers, policy makers, payers [including insurers and employers], product manufacturers) to take part in evidence generation and benchmarking. CERTAIN continues to prioritize incorporating patients’ perceptions of their health, including well-being and quality of life, perceptions of disability and level of impairment into routine healthcare surveillance and quality improvement. The Patient Advisory Network is a community of over 150 patients, caregivers and family members who act alongside CERTAIN to improve healthcare, make research better and reflect the patient perspective. The CERTAIN Hub has recently launched as a web-based portal for improving patient data collection and for delivering programs aimed at improving health and healthcare. In total, CERTAIN has surveyed over 20,000 patients about their surgical health care experiences. Strong for Surgery, a CERTAIN program that was launched in May of 2012, continues to engage with Washington State hospitals and clinics to make evidence-based best practices the standard of care. Strong for Surgery encourages the use of checklists in the days and weeks before surgery to improve surgical outcomes and reduce unnecessary healthcare costs due to complications. Over the past year, we have implemented the Strong for Surgery nutrition checklist at 50 partner sites across five surgical specialties, with 205 participating surgeons.

Impact in Washington

Location of LSDF Grantee
Locations of Collaborations/Areas of Impact

Legislative Districts:
3, 4, 6, 11, 22, 34, 36, 37, 43, 46, 48

Health Impacts

Comparative Effectiveness Research