Institute for Healthcare Improvement: BTS Collaborative: Reducing Surgical Site Infections

Overview

The Breakthrough Series is IHI’s collaborative improvement methodology to rapidly deploy major changes that produce breakthrough results in a specific clinical or operational area. Collaboratives last for approximately 10 months under the guidance of an IHI panel of experts, and are open to IMPACT and non-IMPACT member organizations.

Enrollment for this program is closed. If you are interested in receiving information for the next offering of this program, please send an email to info@ihi.org.

Click here to listen to an informational call led by the faculty of this Collaborative.

The Problem

The Solution

Postoperative infection is a major cause of patient injury, mortality, and health care cost. Between 2% and 5% of nearly 30 million operations are complicated by surgical site infections (SSIs) each year, and each infection is estimated to increase a hospital stay by an average of seven days.

Moreover, patients who develop surgical site infections are 60% more likely to spend time in an ICU, are five times more likely to be readmitted to the hospital, and have twice the incidence of mortality.

Despite advances in infection control practices, surgical site infections remain a substantial cause of morbidity and mortality among hospitalized patients.

Effective surgical infection prevention and harm reduction require redesigning systems with safety in mind. This applies to all forms of performance — such as selection, timing, and duration of antimicrobial prophylaxis; thermoregulation; oxygen tension; glucose control; hair removal; and other basic prevention strategies.

Systemic and process changes that promote compliance with established guidelines and standards can decrease infectious morbidity. Appropriate preoperative administration of antibiotics is effective in preventing infection.

This Breakthrough Series Collaborative will help participants deploy a safe, high reliability surgical system to significantly reduce SSIs.

Areas of Focus

To decrease morbidity and mortality associated with postoperative infection through:

Appropriate and timely prophylactic antibiotic administration
Appropriate hair removal
Perioperative glucose control
Perioperative supplemental oxygen
Controlled perioperative normothermia
Improved operating room culture

Aims

Participants will implement a proven change package for achieving the following goals:

Double the number of surgical cases between SSIs
100% compliance with appropriate selection and timing of prophylactic antibiotic administration:
- Fully administered within one hour prior to incision
- Consistent with published guidelines
- Discontinued within 24 hours after surgery

Related Learning Opportunity

Creating High-Performance Teams

Jump start your group into becoming a team by attending a one-day workshop on creating effective teams, offered prior to the first Learning Sessions.