Perioperative antibiotic process improvement reaps rewards.

Area of Science:

• Healthcare Improvement
• Surgical Infection Prevention
• Health Economics

Background:

• Healthcare initiatives increasingly link financial incentives to performance measures.
• Prophylactic antibiotic use is critical in preventing surgical site infections.
• Optimizing the timing of antibiotic administration is a key performance indicator.

Purpose of the Study:

• To evaluate the impact of a collaborative prophylactic antibiotic use program on compliance rates.
• To assess the effect of assigning responsibility for timely antibiotic prophylaxis (TAP) to the Anesthesiology department.
• To determine the return on investment (ROI) of the implemented antibiotic protocol.

Main Methods:

• A collaborative protocol was developed involving Surgery, Infection Control, and Anesthesiology.
• Anesthesiology assumed responsibility for administering timely antibiotic prophylaxis (TAP) before surgical incision.
• Data from a 12-month period before and after implementation were compared using z tests and chi-squared analysis.

Main Results:

• Timely antibiotic prophylaxis (TAP) compliance rates significantly increased from 75.1% to 89.3% (P < .001).
• Factors influencing TAP failure included prolonged time from anesthesia induction to incision, surgical procedure type, antibiotic choice, and anesthesia provider.
• The program yielded a substantial return on investment (ROI) of 2.2.

Conclusions:

• Anesthesiology assuming responsibility for TAP significantly improved compliance rates.
• Anesthesia providers are a critical factor in successful prophylactic antibiotic administration.
• The program demonstrated both improved clinical outcomes (compliance) and economic benefits (ROI).