Reducing colorectal surgical site infections: a novel, resident-driven, quality initiative

Daniel Brock Hewitt, Sami S. Tannouri, Richard A. Burkhart, Randi Altmark, Scott D. Goldstein, Gerald A. Isenberg, Benjamin R. Phillips, Charles J. Yeo, Scott W. Cowan

Research output: Contribution to journalArticlepeer-review

Abstract

Background Surgical site infections (SSIs) cause significant patient morbidity and increase costs. This work prospectively examines our institutional effort to reduce SSIs through a resident-driven quality initiative. Methods A general surgery resident-championed, evidenced-based care bundle for patients undergoing colorectal surgery at a single academic institution was developed using attending mentorship. National Surgical Quality Improvement Program definitions for SSIs were used. Data were collected prospectively and bundle compliance was monitored using a checklist. The primary outcome compared SSIs before and after implementation. Results In the 2 years preceding standardization, 489 colorectal surgery cases were performed. SSIs occurred in 68 patients (13.9% SSI rate). Following implementation of the bundle, 212 cases were performed with 10 SSIs (4.7% SSI rate, P <.01). Multivariate logistic regression analysis found a decrease in superficial and overall SSIs (odds ratio.17, 95% confidence interval.05 to.59; odds ratio.31, 95% confidence interval.14 to.68). Conclusions These data demonstrate that resident-driven initiatives to improve quality of care can be a swift and effective way to enact change. We observed significantly decreased SSIs with a renewed focus on evidence-based, standardized patient care.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalAmerican journal of surgery
Volume213
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Keywords

  • Colorectal
  • Outcomes
  • Quality
  • Resident
  • Surgical site infection

ASJC Scopus subject areas

  • Surgery

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