Reduction of surgical site infections in colorectal surgery: A 10-year experience from an independent academic medical center.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
06 2019
Historique:
received: 09 03 2018
revised: 31 10 2018
accepted: 08 11 2018
pubmed: 26 11 2018
medline: 14 1 2020
entrez: 26 11 2018
Statut: ppublish

Résumé

Surgical site infections (SSI) are a source of patient morbidity and increased cost. In 2007, our organization discovered an SSI rate of 18% after colorectal surgery (CRS), corresponding to an ACS NSQIP benchmarked high outlier. From 2007 to 2016, surgeons championed a stepwise, multidisciplinary improvement pathway for SSI reduction. NSQIP was used to track SSI rates and estimate cost savings. From 2007 to 2016, 1508 patients underwent CRS at our facility. In 2007, our SSI rate was 18%. In 2016, the SSI rate was 7%, corresponding to a NSQIP benchmarked exemplary performance. 54 patients avoided the morbidity of a SSI. The expense of SSI reduction implementation was $180,000. Cost savings was estimated at $1.3 million. Our approach reduced SSI rates by 58% over ten years. We observed a significant morbidity reduction and cost savings. Our strategy could be adopted within other medical centers focused on CRS SSI improvement.

Sections du résumé

BACKGROUND
Surgical site infections (SSI) are a source of patient morbidity and increased cost. In 2007, our organization discovered an SSI rate of 18% after colorectal surgery (CRS), corresponding to an ACS NSQIP benchmarked high outlier.
METHODS
From 2007 to 2016, surgeons championed a stepwise, multidisciplinary improvement pathway for SSI reduction. NSQIP was used to track SSI rates and estimate cost savings.
RESULTS
From 2007 to 2016, 1508 patients underwent CRS at our facility. In 2007, our SSI rate was 18%. In 2016, the SSI rate was 7%, corresponding to a NSQIP benchmarked exemplary performance. 54 patients avoided the morbidity of a SSI. The expense of SSI reduction implementation was $180,000. Cost savings was estimated at $1.3 million.
CONCLUSIONS
Our approach reduced SSI rates by 58% over ten years. We observed a significant morbidity reduction and cost savings. Our strategy could be adopted within other medical centers focused on CRS SSI improvement.

Identifiants

pubmed: 30471811
pii: S0002-9610(18)30356-8
doi: 10.1016/j.amjsurg.2018.11.010
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1089-1093

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Nolan J Rudder (NJ)

Department of Medical Education, Gundersen Medical Foundation, La Crosse, WI, USA.

Andrew J Borgert (AJ)

Department of Medical Research, Gundersen Medical Foundation, La Crosse, WI, USA.

Kara J Kallies (KJ)

Department of Medical Research, Gundersen Medical Foundation, La Crosse, WI, USA.

Travis J Smith (TJ)

Department of General Surgery, Gundersen Health System, La Crosse, WI, USA.

Stephen B Shapiro (SB)

Department of General Surgery, Gundersen Health System, La Crosse, WI, USA. Electronic address: sbshapir@gundersenhealth.org.

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