Clinical ScienceReducing colorectal surgical site infections: a novel, resident-driven, quality initiative
Section snippets
Study design
Institutional Review Board approval at Thomas Jefferson University Hospital was obtained. Institutional ACS-NSQIP colorectal data on all nonemergent cases from January 1, 2012 to February 28, 2015 were reviewed. Cases included both open and laparoscopic procedures including the following: partial or total colectomy with or without proctectomy, Hartmann-type procedure, total abdominal colectomy with or without proctectomy, proctectomy, or excision of rectal procidentia (including the following
Results
Seven hundred and one (n =701) consecutive patients who underwent nonemergent colorectal operations from January 2012 to February 2015 at the Thomas Jefferson University Hospital were included in the analysis, and divided into 2 cohorts: preintervention and postintervention. There was no significant difference between pre- and postintervention characteristics such as age, sex, body mass index, smoking status, diabetes, steroid use, and American Society of Anesthesiologists class. The only
Comments
It is now an Accreditation Council for Graduate Medical Education requirement that surgical residents “actively participate in interdisciplinary clinical quality improvement and patient safety programs.” In response to this requirement, our general surgical residency program developed QBIRT: Quality Based Improvement Resident Teams, a resident-championed quality improvement program. Residents form teams containing one resident from each postgraduate year of training. Each team chooses a quality
Conclusion
We have demonstrated that a resident-driven quality initiative can provide a swift and effective avenue to enact change and improve the quality of patient care, particularly in an academic setting that empowers all members of the medical community to focus on quality-driven care.
Acknowledgments
We acknowledge Dr Scott Keith for assistance with the statistical analysis. We would also like to acknowledge the countless operating room staff, scrub nurses, and administrators who helped shape this intervention and who have diligently carried out its practice every day.
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Cited by (18)
Surgical site infection prevention bundle in elective colorectal surgery
2022, Journal of Hospital InfectionEvidence-Based Bundled Quality Improvement Intervention for Reducing Surgical Site Infection in Lower Extremity Vascular Bypass Procedures
2019, Journal of the American College of SurgeonsColon and rectal surgery surgical site infection reduction bundle: To improve is to change
2019, American Journal of SurgeryCitation Excerpt :However, despite its introduction and implementation at numerous hospitals across the country, surgical site infections remain a source of morbidity.1 Consequently, due to the large number of elective colorectal operations performed annually, there remains increased scrutiny on various best-practice methods to reduce surgical site infections and their associated morbidity7,8. Individual elements of these efforts vary across institutions, however the overall results are promising in reduction of overall infection rates.
Implementation of an abdominal closure bundle to reduce surgical site infection in patients on a gynecologic oncology service undergoing exploratory laparotomy
2018, Gynecologic OncologyCitation Excerpt :Multiple intrinsic and extrinsic factors such as patient age, BMI, diabetes, tobacco use, blood transfusion, length of procedure, hospital length of stay, and wound classification, have been identified as SSI risk factors [1,24]. In addition, both the colorectal and the gynecologic oncology literature are conflicted as to whether or not patients with bowel resection benefit from SSI reduction bundles [2,6,10,11,13,14,25,26]. In our study population, significantly fewer bowel resections were performed in the post-bundle period (17% pre-bundle vs. 9% post-bundle).
Surgical site infection reduction bundle in patients with gynecologic cancer undergoing colon surgery
2017, Gynecologic OncologyCitation Excerpt :A key component of our initial quality improvement prospectus was the creation of interdepartmental teams to review the literature and collectively decide upon bundled interventions and their implementation. This aspect of reduction bundling is similarly supported and emphasized throughout the literature [1,2,11,15]. Furthermore, the ongoing issues of compliance and monitoring are integral to the creation and success of an SSI reduction bundle program.
Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update
2023, Infection Control and Hospital Epidemiology
The authors declare no conflicts of interest.