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Study: Hospitals cut surgical infections by 27% in one year

Quality Improvement Monitor, July 1, 2005

Fifty-six hospitals from 50 states and U.S. territories cut the rate of surgical infections for more than 35,000 patients in a yearlong, nationwide effort sponsored by CMS and a quality improvement organization (QIO), according to study published in the June 23 American Journal of Surgery.

Forty-four hospitals that provided data throughout the collaborative reduced their surgical site infection rate by 27%. CMS and Qualis Health, the QIO for Alaska, Idaho, and Washington, led the project.

All teams in the collaborative agreed to focus on improving performance on three processes that CMS uses as national quality measures: administration of antibiotics within 60 minutes of surgical incision, use of appropriate antibiotics, and discontinuation of antibiotics within 24 hours of the end of surgery.

Most of the teams also worked on improving performance on one or more of the following: control of glucose levels during surgery, avoiding hypothermia during surgery, use of supplemental oxygen during surgery and recovery, and clipping rather than shaving the surgical site.

Over the course of the collaborative, the median performance of participating hospital teams improved on all process measures. The overall infection rate fell more than a quarter, from 2.3% in the first three months of the collaborative to 1.7% in the last three months.

Conducted in 2002-2003, the National Surgical Infection Prevention Collaborative also involved 43 QIOs working under contract to CMS and laid the groundwork for ongoing QIO assistance to help groups of hospitals in every state prevent surgical infections.

A major cause of preventable morbidity and mortality in hospitals, surgical site infections complicate an estimated 780,000 operations each year.

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