Colorectal surgical site infection reduction strategies

Abstract

Objective: PeaceHealth Sacred Heart Medical Center at RiverBend is a 379 bed hospital; 15,060 surgical procedures were performed in 2014 with 254 being colorectal surgical cases. Using the ACS NSQIP program the hospital was identified as a high outlier for surgical site infection (SSI) in all cases and in colorectal procedures in our July 2012 semiannual report (SAR).

Methods: A best practice bundle to reduce SSI's and a colorectal enhanced recovery pathway were concurrently initiated

Results: After implementation of these best practice elements, our ACS NSQIP results showed a reduction in our colorectal SSI rate from 17.58% for 2011 to 5.11% (1st decile/low outlier) in the January 2015 SAR. Our SSI rate for all cases were reduced from 4.87% to 1.71% (1st decile/low outlier) during the same time period. A reduction in length of stay for our colorectal surgical patients was also noted.

Conclusions: The ACS NSQIP program was essential to identify colorectal SSI as an area of concern and for providing data to drive quality improvement measures.

Keywords: ACS NSQIP; Colorectal surgery; SSI; Surgical site infections.