Celebrating 10 Years of Advancing Surgical Quality in Ontario with ONSQIN
A high-performing health care system is built on a culture of continuous learning and improvement. For the past decade, the Ontario Surgical Quality Improvement Network (ONSQIN) has embodied this principle, advancing surgical care by fostering collaboration, transparency and innovation across the province. What began as a bold idea among 16 hospitals has evolved into a thriving community of practice, connecting over 50 surgical teams across Ontario with a shared commitment to improving care.
ONSQIN has shown what’s possible when hospitals work together instead of in isolation. By sharing data, insights and strategies, we’ve elevated the standard of surgical care across Ontario. Most importantly, it has helped reduce disparities between hospitals and ensured patients receive consistently high-quality surgical care. That is the true strength of working as a coordinated provincial network.”
ONSQIN Clinical Lead
Building a Strong Foundation for Surgical Excellence
Established in 2015, ONSQIN was created with a clear vision: to ensure every patient in Ontario receives safe, high-quality surgical care. Participating hospitals join the American College of Surgeons National Surgical Quality Improvement Program, committing to submitting a minimum of 1,680 surgical cases per year. These cases with risk-adjusted data offer actionable insights into performance, highlighting strengths and opportunities for improvement.
Ontario Health supports this work by fostering a provincial community of practice, as well as providing data monitoring, monthly meetings and coordinated quality improvement campaigns that connect surgical teams around shared priorities. Today, 54 hospital sites participate in ONSQIN’s community of practice, the largest and most collaborative surgical improvement network in Canada.
Meaningful Improvements in Patient Outcomes
From the beginning, the value of ONSQIN has been clear. Better data leads to better decisions and better care. Over the past decade, participating hospitals have seen reductions in postoperative complications, shorter hospital stays, fewer readmissions and improved patient satisfaction. For surgical teams, the network provides trusted performance information and a platform to learn from peers. For hospitals, these improvements translate into stronger outcomes and lower costs through avoided complications.
The results speak for themselves – and represent meaningful benefits for patients and families. Across participating hospitals, ONSQIN has consistently delivered measurable improvements in patient safety and postoperative recovery.
Since 2015, surgical teams at participating hospitals have achieved significant reductions in major surgical complications:
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14%
decrease in surgical site infections
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33%
decrease in urinary tract infections
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14%
decrease in pneumonia
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20.6%
decrease in mortality
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6.5%
decrease in morbidity
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17%
decrease in unplanned readmissions to hospital
Driving Value and Health System Sustainability
ONSQIN strengthens not only clinical outcomes, but the health care system. A formal program evaluation in 2023 reinforced the network’s impact. By preventing complications and enhancing surgical efficiency, ONSQIN is saving the system $3 million annually, delivering a 38 per cent return on investment. Hospitals also report 375 to 631 days saved in length of stay per site, easing patient flow and supporting broader sustainability efforts.
Collaboration Becomes Transformation
Over the past decade, ONSQIN has launched targeted, evidence-based campaigns to reduce surgical site infections, improve opioid stewardship (interventions that improve, monitor and evaluate the use of opioids), enhance surgical recovery, prevent hospital-acquired delirium and reduce surgical waste. Each campaign builds on the last, creating a cycle of learning and improvement that has inspired similar collaborative models in other areas of care.
Looking Ahead: Closing the Quality Gap Together
With a strong foundation, proven results and a committed clinical community, Ontario is well positioned to continue closing surgical quality gaps. Learn more about ONSQIN and how surgical care professionals can join the community of practice to help improve patient experience across the province.
Last Updated: May 12, 2026
