Surgical site infections are a nasty and persistent problem throughout the U.S. healthcare system, and affect as many as 5 percent of patients who undergo surgery.
And with the rise of “superbugs,” or drug-resistant infections, the problem doesn’t appear to be going away any time soon. The cost to the U.S. health system of each surgical site infection averages more than $25,000, according to a report in Infection Control Today.
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But a group of eight children’s hospitals in Ohio has banded together to fight surgical site infections (SSIs) and achieved impressive success: a collective 60 percent reduction in SSIs. The project focused on children undergoing some of the most complicated types of surgery, such as spine or brain, said Dr. Anne Lyren, director of quality and ethics with University Hospitals Rainbow Babies & Children’s Hospital in Cleveland.
“These are some of the most compromised children, so the likelihood of them getting a post-surgical infection is significant,” Lyren said.
Lyren shared a few tips on how Rainbow Babies & Children’s cut its rate of SSIs that could be useful to other hospitals exploring ways of taking a bite out of this vexing problem. “It’s not just as simple as washing your hands,” she said. “Some of these bacteria are formidable foes.”
Collaboration is key: Improvement at individual hospitals wouldn’t have happened without collaboration. That enabled all eight hospitals to pool their data and have a much larger amount of cases to study. “It’s sort of hard to learn just from inside one organization,” Lyren said.
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It won’t happen without strong leadership: If a group of hospitals that typically compete is going to collaborate on best practices, strong buy-in from all the hospitals’ leadership is a must. Leaders from the Ohio children’s hospitals reached an agreement that they wouldn’t compete on safety, Lyren said.
Don’t forget the antibiotics: In terms of process improvement, hospitals need to put in place clear measures that ensure patients are receiving antibiotics when appropriate before, during and after surgeries. Most hospitals do this right most of the time, but it’s important to establish procedures that lead to doing it right every time. “These are very complex surgeries with lots going on and lots of people involved,” Lyren said. “Who owns the process? How are you sure it’s not going to be forgotten?”
Establish rigorous processes around skin scrubbing and preparation: This again sounds like basic blocking and tackling, but the key is putting in place an easily replicable process that is followed for each and every surgery.
[Photo from flickr user Army Medicine]
