Improving Postoperative Outcomes in Lower Extremity Amputees Utilizing a Quality Improvement Approach

This project focused on adult lower extremity amputees from March 2017 through March 2019. The aim was to improve 30-day surgical site infection (SSI) rates by 10% in two orthopaedic populations. Subaims focused on 30-day readmission rates, length of stay, and 30-day mortality rates. The primary intervention of incisional negative pressure wound vac therapy (iNPWT) device application was instituted. This was supported by World Health Organization recommendations, meta-analyses, and consensus statements advising the utilization of iNPWT devices. Plan-Do-Study-Act cycles were aimed at education, operation efficiency, and patient engagement. By March 2019, goals were met for SSI and 30-day readmission rates in each division. Cost analysis showed a savings of $38,500. Improved clinical significance was noted in SSI rates, 30-day readmission rates, and cost in lower extremity amputees. It is unclear whether the innovation led to improvement in the other subaims; however, this revealed areas for additional areas for improvement.