Decreasing prosthetic joint surgical site infections: an interdisciplinary approach

As of October 2013, a hospital's base Medicare reimbursement will be penalized for patients readmitted within 30 days of undergoing elective total hip and knee arthroplasties. To respond to an increased incidence of prosthetic joint infections after these surgeries, members of an interdisciplinary project team at a 1,046-bed multihospital health care organization in the southeastern United States sought to identify factors that place patients at high risk for infection. Data showed that addressing the sterile environment, personnel issues, patient readiness for surgery, and system issues resulted in decreased rates of infection among patients who underwent hip replacement surgery (χ(2)1 = 3.057, P = .04). Additional outcomes included decreased reliance on immediate-use steam sterilization and a standardized method to educate perioperative and radiology department personnel regarding prevention of prosthetic joint infections. The team concluded that an interdisciplinary approach to process improvement is effective and economical.