Colorectal surgical site infection reduction strategies

Area of Science:

• Healthcare Quality Improvement
• Surgical Infection Prevention
• Colorectal Surgery Outcomes

Background:

• PeaceHealth Sacred Heart Medical Center identified as a high outlier for surgical site infections (SSI) by the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).
• High SSI rates were noted in both all surgical cases and specifically in colorectal procedures as of July 2012.

Purpose of the Study:

• To reduce high surgical site infection (SSI) rates identified through the ACS NSQIP program.
• To improve outcomes for colorectal surgical procedures.

Main Methods:

• Implementation of a best practice bundle aimed at reducing SSIs.
• Concurrent initiation of a colorectal enhanced recovery pathway.

Main Results:

• Colorectal SSI rate decreased from 17.58% (2011) to 5.11% (January 2015 SAR), achieving the 1st decile/low outlier status.
• Overall SSI rate for all cases reduced from 4.87% to 1.71% during the same period, also reaching 1st decile/low outlier status.
• A reduction in the length of stay for colorectal surgical patients was observed.

Conclusions:

• The ACS NSQIP program was crucial in identifying colorectal SSI as a quality concern.
• Data from ACS NSQIP effectively drove targeted quality improvement measures.
• The implemented strategies successfully reduced SSI rates and improved patient outcomes.