Forty-five-bed Porter Hospital, located in Middlebury, Vermont, is demonstrating that improving care and outcomes isn’t strictly the purview of large institutions. Since participating in an IHI Collaborative and joining IHI’s IMPACT network, Porter has dropped its surgical site infection (SSI) rate from almost three percent in October 2004 to zero — meaning 357 infection-free surgical cases, and counting — through September 2005.
Porter staff members have reliably implemented ideal perioperative care for all surgical patients, one of the six interventions in IHI’s 100,000 Lives Campaign. This includes appropriate use of antibiotics before and after surgery, razorless hair removal (or none at all), and maintenance of normal body temperature during and after surgery. “We use a machine that scans the temporal artery, which is equivalent to core body temperature so we’re always sure the patient is warm enough,” says Performance Manager, Ann Beauregard, RN, BA. Beauregard says they are also beginning to implement tight glucose control after surgery.
Monthly data reports are widely distributed (and eagerly anticipated by staff). The hospital’s small size means everyone stays in the loop — “we all eat lunch together,” says Beauregard — but doesn’t mean they think small. “We are beginning two more big projects with IHI: redesigning the office practice, and improving patient flow through the hospital.”
