OBJECTIVES: The objective of this study was to evaluate whether the Surgical Care Improvement Project (SCIP) improved surgical site infection (SSI) rates using national data at the patient level for both SCIP adherence and SSI occurrence. BACKGROUND: The SCIP was established in 2006 with the goal of reducing surgical complications by 25% in 2010. METHODS: National Veterans' Affairs (VA) data from 2005 to 2009 on adherence to 5 SCIP SSI prevention measures were linked to Veterans' Affairs Surgical Quality Improvement Program SSI outcome data. Effect of SCIP adherence and year of surgery on SSI outcome were assessed with logistic regression using generalized estimating equations, adjusting for procedure type and variables known to predict SSI. Correlation between hospital SCIP adherence and SSI rate was assessed using linear regression. RESULTS: There were 60,853 surgeries at 112 VA hospitals analyzed. SCIP adherence ranged from 75% for normothermia to 99% for hair removal and all significantly improved over the study period (P < 0.001). Surgical site infection occurred after 6.2% of surgeries (1.6% for orthopedic surgeries to 11.3% for colorectal surgeries). None of the 5 SCIP measures were significantly associated with lower odds of SSI after adjusting for variables known to predict SSI and procedure type. Year was not associated with SSI (P = 0.71). Hospital SCIP performance was not correlated with hospital SSI rates (r = -0.06, P = 0.54). CONCLUSIONS: Adherence to SCIP measures improved whereas risk-adjusted SSI rates remained stable. SCIP adherence was neither associated with a lower SSI rate at the patient level, nor associated with hospital SSI rates. Policies regarding continued SCIP measurement and reporting should be reassessed.
OBJECTIVES: The objective of this study was to evaluate whether the Surgical Care Improvement Project (SCIP) improved surgical site infection (SSI) rates using national data at the patient level for both SCIP adherence and SSI occurrence. BACKGROUND: The SCIP was established in 2006 with the goal of reducing surgical complications by 25% in 2010. METHODS: National Veterans' Affairs (VA) data from 2005 to 2009 on adherence to 5 SCIP SSI prevention measures were linked to Veterans' Affairs Surgical Quality Improvement Program SSI outcome data. Effect of SCIP adherence and year of surgery on SSI outcome were assessed with logistic regression using generalized estimating equations, adjusting for procedure type and variables known to predict SSI. Correlation between hospital SCIP adherence and SSI rate was assessed using linear regression. RESULTS: There were 60,853 surgeries at 112 VA hospitals analyzed. SCIP adherence ranged from 75% for normothermia to 99% for hair removal and all significantly improved over the study period (P < 0.001). Surgical site infection occurred after 6.2% of surgeries (1.6% for orthopedic surgeries to 11.3% for colorectal surgeries). None of the 5 SCIP measures were significantly associated with lower odds of SSI after adjusting for variables known to predict SSI and procedure type. Year was not associated with SSI (P = 0.71). Hospital SCIP performance was not correlated with hospital SSI rates (r = -0.06, P = 0.54). CONCLUSIONS: Adherence to SCIP measures improved whereas risk-adjusted SSI rates remained stable. SCIP adherence was neither associated with a lower SSI rate at the patient level, nor associated with hospital SSI rates. Policies regarding continued SCIP measurement and reporting should be reassessed.
Authors: Elisabeth Maurer; Alexander Reuss; Katja Maschuw; Behnaz Aminossadati; Thomas Neubert; Carmen Schade-Brittinger; Detlef K Bartsch Journal: Dtsch Arztebl Int Date: 2019-05-24 Impact factor: 5.594
Authors: Mahsa Mohiti-Asli; Marije Risselada; Megan Jacob; Behnam Pourdeyhimi; Elizabeth G Loboa Journal: Tissue Eng Part C Methods Date: 2017-09-19 Impact factor: 3.056
Authors: J Tanner; M Kiernan; R Hilliam; S Davey; E Collins; T Wood; J Ball; D Leaper Journal: Ann R Coll Surg Engl Date: 2016-02-29 Impact factor: 1.891
Authors: Nader N Massarweh; Chung-Yuan Hu; Y Nancy You; Brian K Bednarski; Miguel A Rodriguez-Bigas; John M Skibber; Scott B Cantor; Janice N Cormier; Barry W Feig; George J Chang Journal: J Clin Oncol Date: 2014-09-20 Impact factor: 44.544