QIOs Target Surgical Infections
Quality Improvement
Organizations are working with hospitals in every state to reduce the incidence
of surgical site infections. The Surgical Infection Prevention (SIP) project – a national QIO effort that began in late
2002 – is sponsored by the Centers for Medicare and Medicaid Services
( CMS) and the Centers for Disease Control and Prevention (CDC) at the U.S.
Department of Health and Human Services.
Improving the selection and timing of administration of prophylactic antibiotics
are major goals of the national project. An estimated 2.6 percent of nearly
30 million operations are complicated by surgical site infections each year,
causing a significant amount of patient injury, mortality and often avoidable
costs for both patients and hospitals. Research studies show that one-third
to one-half of these infections can be avoided with appropriate use of prophylactic
antibiotics.
The SIP project focuses on improving hospital procedures known to have an
impact on reducing surgical infections. Specifically, the project seeks to
increase:
- The proportion of patients who receive antibiotics within one hour before
incision.
- The proportion of patients who receive prophylactic antibiotics consistent
with current recommendations.
- The proportion of patients whose prophylactic antibiotics are discontinued
within 24 hours of surgery end time. This is an effort to limit resistance
to antibiotic treatment.
The effort focuses on surgical procedures among the Medicare population,
including: coronary artery bypass graft (CABG), cardiac surgery, colon surgery,
hip and knee arthroplasty, abdominal and vaginal hysterectomy, and selected
vascular procedures, such as vein bypass and repair of aneurysm.
Most QIOs have been working to reduce surgical infections by using an innovative
collaborative model, pioneered by the Institute for Healthcare Improvement,
to effectively change clinical care processes in hospitals. QIOs were trained
in the use of these IHI-style collaboratives in a national pilot project
conducted by Qualis Health, a Seattle-based QIO, during 2002-2003.
The SIP Project is administered by the Oklahoma Foundation for Medical Quality,
the QIO for Oklahoma, and advised by a panel of experts from more than a
dozen national organizations, including: the American Academy of Orthopedic
Surgeons, American College of Surgeons, American Hospital Association, JCAHO,
VHA, Surgical Infections Society, Association of periOperative Registered
Nurses, Society of Thoracic Surgeons, and the American Society of Anesthesiologists.
For
more information on the SIP project: www.medqic.org/sip
The American Health Quality Association is dedicated to improving the safety
and effectiveness of health care. AHQA represents the national network of
Quality Improvement Organizations (QIOs) that work with hospitals, medical
practices, health plans, long-term care facilities, home health agencies,
and employers to encourage the spread of best clinical practices and improve
systems of care delivery. Visit: www.ahqa.org. |
