Reducing colorectal surgical site infections: a novel, resident-driven, quality initiative.
Publication/Presentation Date
1-1-2017
Abstract
BACKGROUND: Surgical site infections (SSIs) cause significant patient morbidity and increase costs. This work prospectively examines our institutional effort to reduce SSIs through a resident-driven quality initiative.
METHODS: A general surgery resident-championed, evidenced-based care bundle for patients undergoing colorectal surgery at a single academic institution was developed using attending mentorship. National Surgical Quality Improvement Program definitions for SSIs were used. Data were collected prospectively and bundle compliance was monitored using a checklist. The primary outcome compared SSIs before and after implementation.
RESULTS: In the 2 years preceding standardization, 489 colorectal surgery cases were performed. SSIs occurred in 68 patients (13.9% SSI rate). Following implementation of the bundle, 212 cases were performed with 10 SSIs (4.7% SSI rate, P < .01). Multivariate logistic regression analysis found a decrease in superficial and overall SSIs (odds ratio .17, 95% confidence interval .05 to .59; odds ratio .31, 95% confidence interval .14 to .68).
CONCLUSIONS: These data demonstrate that resident-driven initiatives to improve quality of care can be a swift and effective way to enact change. We observed significantly decreased SSIs with a renewed focus on evidence-based, standardized patient care.
Volume
213
Issue
1
First Page
36
Last Page
42
ISSN
1879-1883
Published In/Presented At
Hewitt, D. B., Tannouri, S. S., Burkhart, R. A., Altmark, R., Goldstein, S. D., Isenberg, G. A., Phillips, B. R., Yeo, C. J., & Cowan, S. W. (2017). Reducing colorectal surgical site infections: a novel, resident-driven, quality initiative. American journal of surgery, 213(1), 36–42. https://doi.org/10.1016/j.amjsurg.2016.04.009
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
27427296
Department(s)
Administration and Leadership
Document Type
Article