Committed to Better Outcomes: Reducing Infection after Surgery Across the Ontario Surgical Quality Improvement Network
| Autor: | Nancy Ahmad, Avery B. Nathens, Pierrette Price Arsenault, David Schramm, Husein Moloo, Tim Jackson, Tricia Beath, Azusa Maeda |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Quality management 03 medical and health sciences 0302 clinical medicine Risk Factors Surgical site medicine Humans Surgical Wound Infection Intersectoral Collaboration Ontario Priority setting business.industry Incidence Incidence (epidemiology) Pneumonia medicine.disease Quality Improvement Acs nsqip Surgical Procedures Operative 030220 oncology & carcinogenesis Urinary Tract Infections Emergency medicine 030211 gastroenterology & hepatology Surgery business Surgical site infection Program Evaluation |
| Zdroj: | Journal of the American College of Surgeons. 233:204-211 |
| ISSN: | 1072-7515 |
| DOI: | 10.1016/j.jamcollsurg.2021.04.027 |
| Popis: | BACKGROUND In 2015, the Ontario Surgical Quality Improvement Network was established to create a community of practice for Ontario hospitals to improve surgical quality. A provincial campaign to decrease postsurgical infections was launched in 2017. STUDY DESIGN Thirty hospitals implemented activities related to the campaign from April 2018 to March 2019. The community of practice was used to disseminate suggested change ideas in each area. Self-reported data from participating hospitals and collaborative-wide aggregate risk-adjusted data from the American College of Surgeons NSQIP were reviewed to determine the impact of the campaign on the rates of postoperative surgical site infections (SSIs), urinary tract infections (UTIs), and pneumonia. RESULTS A total of 24, 8, and 2 hospitals selected SSIs, UTIs, and pneumonia, respectively, as their targets for improvement. Three hospitals selected both SSIs and UTIs, 1 hospital selected SSIs and pneumonia, and 1 hospital selected all 3 indicators as targets. Self-reported data demonstrated that the rates of SSIs and UTIs decreased significantly post campaign from 4.87% to 3.99% (p < 0.0001) and from 3.65% to 1.25% (p = 0.007), respectively. Pneumonia rates also decreased from 1.27% to 1.05%. Overall rates of SSIs, UTIs, and pneumonia across all Ontario Surgical Quality Improvement Network hospitals were reduced from 3.4%, 1.29%, and 0.88% to 3.37%, 1.14%, and 0.84%, respectively. CONCLUSIONS The 1-year campaign resulted in a clinically significant reduction in the rates of SSIs and UTIs, as well as a trend for decrease in pneumonia incidence among participating hospitals. Using a flexible approach with priority setting and leveraging the community of practice for dissemination of change ideas is an effective way of sustaining quality improvement activities. |
| Databáze: | OpenAIRE |
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