Surgical Site Infections
Category Type: Quality of Care/Patient Safety
In August 2010, the Center for Transforming Healthcare will launch its fourth project which aims to reduce surgical site infections (SSI). This project is launched in collaboration with the American College of Surgeons and uses data derived from the ACS’s National Surgical Quality Improvement Program (NSQIP). NSQIP data on outcomes of surgery are highly regarded by physicians as clinically valid, using detailed medical information on severity of illness and comorbidity to produce exemplary data on risk-adjusted outcomes.
Surgical site infections are a major cause of patient injury, mortality, health care cost, and prolonged hospitalization. The Centers for Disease Control and Prevention estimates that approximately 290,000 SSIs occur every year and are associated with approximately 8,000 patient deaths annually. SSI is also one of the most prevalent negative outcomes reported by NSQIP hospitals.
The Center worked with the ACS to determine the scope of the SSI project, since there is a wide range of surgeries and procedures that can develop SSIs – each with its own unique set of complications and challenges. To help narrow the scope of the project, the following criteria were used to identify a specific procedure that:
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Is common across different types of hospitals
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Has significant complications with an adverse clinical impact
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Hospitals have significant opportunities to improve performance
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Has high variability in performance across hospitals
Using these criteria, the Center narrowed the scope of the SSI project to colorectal surgery and colorectal procedures, which are often associated with SSIs as reported by NSQIP hospitals.
The Joint Commission Center for Transforming Healthcare uses Robust Process Improvement™ (RPI) methods and tools in the development of its solutions. RPI is a fact-based, systematic, and data-driven problem-solving methodology. It incorporates specific tools and methods from Lean Six Sigma and change management methodologies. Using RPI, project teams can discover specific risk points and contributing factors, and then develop and implement solutions and controls to improve the effectiveness of surgical site infection prevention methods thus increasing overall patient safety and health care quality.
The solutions for this project are targeted for publication in fall of 2011.