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.
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.
Authors: Maria B Schiavone; Lea Moukarzel; Kam Leong; Qin C Zhou; Anoushka M Afonso; Alexia Iasonos; Kara Long Roche; Mario M Leitao; Dennis S Chi; Nadeem R Abu-Rustum; Oliver Zivanovic Journal: Gynecol Oncol Date: 2017-07-19 Impact factor: 5.482
Authors: Katherine E Hekman; Eriberto Michel; Eddie Blay; Irene B Helenowski; Andrew W Hoel Journal: J Am Coll Surg Date: 2018-10-22 Impact factor: 6.113
Authors: Rabie Kilan; Dane Moran; Iyad Eid; Christopher Okeahialam; Corrine Quinn; Wadie Binsaddiq; Tammy Williams; Michael H Johnson Journal: Ann Med Surg (Lond) Date: 2017-06-15