Post-operative colon SSI rate drops more than 70 percent in six months
A workgroup that formed at Good Samaritan last March to halt and reverse the concerning trend of an increase in the colon surgical-site infection rate has been a measurable and resounding success. In fact, the strategies used to curb colon SSIs will be expanded as appropriate to address all surgical-site infections at Good Samaritan.
“A 70-percent drop in just six months! This rapid improvement is a testament to the engaged clinical team at Good Samaritan, always focused on high reliability, teamwork and providing excellent patient care,” said Craig Simmonds, MD, Good Samaritan medical director of Perioperative Services.
“Their outstanding collaboration and deliberate action-planning to address colon SSIs gave us a multitude of improvements that will enhance quality and safety and will save lives.”
Background
In Q1 2024, it was identified that the hospital’s colon surgical-site infection Standardized Infection Rate was above the national benchmark. A closer look at the data revealed the rate had been climbing for two years, leading to an SSI SIR of 2.074, well above the hospital’s target of 0.747 and impacting 13 patients in 2023.
In the US, SSIs remain a substantial cause of morbidity, prolonged hospitalization, readmissions and mortality.
SSI is the costliest type of hospital-acquired infection, with an estimated increased cost in hospitalization of more than $34,000 per admission.
SSIs extend hospital lengths of stay by an average of 9.7 days.
An estimated 11 percent of all deaths occurring in intensive care units are associated with SSIs.
Additionally, SSI SIR data are used nationally to measure hospital quality and safety grades, are reportable to NHSN, Vizient, CMS, Leapfrog and CDPHE, and are publicly reported on Hospital Compare.
Taking action
In March 2024, the hospital established a Colon SSI Workgroup to address this trend. The aim was to rapidly – by the end of the year – reduce the number of colon SSIs. Guided by the mantra, “We Are Better Together,” the multidisciplinary team included surgeons, anesthesiologists, Pharmacy, Nursing leadership, Clinical Excellence, Infection Prevention, dietitians, Physical Therapy, and local and regional executive leadership.
The team reviewed five stages of patient care, from arrival to discharge, and focused on opportunities within each stage.
The actions identified by this group to reduce colon SSIs were implemented in June. These included an increased focus on Enhanced Recovery After Surgery bundle compliance, surgical prep, nutrition, ambulation, temperature management, ostomy care, standardized discharge instructions, documentation of infections Present at the Time of Surgery, referred to as PATOS, and more.
Results
Since July 2024, Good Samaritan has had only one colon SSI, which accounts for a 72 percent decrease in the colon SSI SIR (0.465) for the second half of 2024, and a 43.4 percent decrease year over year. This reduction is estimated to have saved approximately $240,000 in decreased hospitalization costs.
Additionally, the best practices implemented by the Colon SSI Workgroup are being reviewed for expansion and prevention of all surgical-site infections. The SSI Workgroup now includes all SSIs and will partner with regional service line leaders.
Our sincere thanks to everyone involved in this initiative for their significant impact in improving the lives of our patients.
In addition to Simmonds, the medical staff members who participated in this workgroup are:
Vickie Beloy, PA, General Surgery
John Bradley, MD, Anesthesiology
Calli Hintzen, MD, General Surgery
Jason Johnson, DO, General Surgery, and SMD Peaks Surgical Specialties & Digestive Health
Kelly Knudson, MD, General Surgery
Ed Pyun, MD, General Surgery, and GSH chief of staff
Liz Withers, MD, GSH CMO
“I also want to recognize Debbie Lowary, our Clinical Excellence manager, as the one who led this workgroup. She did all the background work and kept everyone on track,” Simmonds said. “The positive result is really testament to her hard work.”
Medical staff members with questions about the now expanded SSI Workgroup can contact Simmonds at craig.simmonds@imail2.org.