How to Improve

Learn about the Model for Improvement, forming the improvement team, setting aims, establishing measures, and selecting and testing changes. Go to How to Improve.

Surgical Site Infection

Surgical site infection (SSI) continues to represent a significant portion of healthcare-associated infections. The impact on morbidity, mortality, and cost of care has resulted in SSI reduction being identified as a top national priority in the US Department of Health and Human Services Action Plan to Prevent Healthcare-Associated Infections.

The majority of SSIs are largely preventable and evidence-based strategies have been available for over ten years and implemented in many hospitals, as nationally recognized by SCIP and SHEA in the US. Worldwide attention to safer surgery including prevention of SSI led to the development of the WHO Surgical Safety Checklist demonstrating the importance of teamwork and communication in addition to evidence-based care for preventing SSI.

How-to Guide: Prevent Surgical Site Infections
This How-to Guide describes key evidence-based care components for preventing surgical site infections, describes how to implement these interventions, and recommends measures to gauge improvement.
World Health Organization (WHO) Surgical Safety Checklist and Getting Started Kit
The Starter Kit, Implementation Manual, and other resources are intended to help hospitals implement the WHO Surgical Safety Checklist, a tool for use by clinicians interested in improving the safety of their operations and reducing unnecessary surgical deaths and complications.

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Integrated Care Pathway for Total Joint Arthroplasty

This Care Pathway provides recommended ideas to improve care for patients receiving total joint arthroplasty (TJA) and includes safe, effective, efficient, and patient-centered TJA care processes. The Pathway is designed for use by all members of the orthopaedic community who are responsible for the TJA process, including those at surgical practices, hospitals, and other care settings.
CHG Bathing Patient Flyer: Prevent Surgical Site Infection for Hip and Knee Arthroplasty

This customizable, educational poster/flyer can be used to inform patients that you encourage them to bathe or shower with chlorhexidine gluconate (CHG) soap to reduce the risk of surgical site infections from hip and knee arthroplasty.
Flyer of Participation: Prevent Surgical Site Infection for Hip and Knee Arthroplasty

This customizable poster/flyer can be used to communicate to your patients that you are focused on reducing surgical site infections for hip and knee arthroplasty.
The Business Case, A Brief for Hospital Administrators: Prevent Surgical Site Infection for Hip and Knee Arthroplasty

Among surgical procedures, arthroplastic (hip and knee) surgeries are key high-cost, high-volume surgeries targeted for surgical site infection (SSI) prevention. This document describes some of the financial implications of SSIs after hip and knee replacement and makes the business case for prevention.
How-to Guide: Prevent Surgical Site Infection for Hip and Knee Arthroplasty

This How-to Guide describes key evidence-based interventions for preventing surgical site infection for patients undergoing hip and knee replacement surgery, describes how to implement these interventions, and recommends measures to gauge improvement.

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One Is Too Many: Viewing Infection Data from the Patient's Perspective

A surgical patient who contracted MRSA following knee replacement surgery describes the effects of the surgical site infection (SSI) on her life, and how her experience led her health care providers to make changes to prevent SSIs.
A Surgeon Talks about Using Alcohol-Based Skin Prep to Prevent SSI

This video offers a surgeon’s perspective on using an alcohol-based antiseptic agent for preoperative skin preparation to reduce the risk of surgical site infection from joint replacement surgery, one the evidence-based interventions recommended in IHI's How-to Guide: Prevent Surgical Site Infection for Hip and Knee Arthroplasty.

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Effectiveness of a Multistate Quality Improvement Campaign in Reducing Risk of Surgical Site Infections Following Hip and Knee Arthroplasty

This article provides an assessment of IHI’s Project JOINTS initiative, a multistate QI campaign to promote adoption of evidence-based practices to reduce surgical site infections (SSIs) following hip and knee arthroplasty.
Does a Quality Improvement Campaign Accelerate Take-up of New Evidence? IHI’s Project JOINTS

IHI’s Project JOINTS initiative engaged a network of state-based organizations and professionals in a six-month QI campaign to promote adherence to three evidence-based practices to reduce surgical site infection (SSI) after joint replacement.
Project JOINTS: What Factors Affect Bundle Adoption in a Voluntary Quality Improvement Campaign?

This article examines how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign — Project JOINTS, an IHI-led initiative — could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty).
Preventing Infection After Hip and Knee Replacements

IHI's Project JOINTS initiative is helping to speed the adoption of proven practices to prevent surgical site infections (SSIs) after hip and knee replacement surgery. This article describes simple, affordable, evidence-based practices organizations can put into place to reduce such infections.
Integrated Care Pathway for Total Joint Arthroplasty

This Care Pathway provides recommended ideas to improve care for patients receiving total joint arthroplasty (TJA) and includes safe, effective, efficient, and patient-centered TJA care processes. The Pathway is designed for use by all members of the orthopaedic community who are responsible for the TJA process, including those at surgical practices, hospitals, and other care settings.

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