Mercy Health Center (Oklahoma City, Oklahoma, USA) reduced post-surgery infections by 78 percent in one year by redesigning systems of care using rapid cycle improvement.
Advances in surgical techniques save and improve lives every day. Unfortunately, there are an estimated 500,000 surgical site infections (SSI) per year in the US, with more than 20,000 resulting in death.
Teams that participated in the National Surgical Infection Prevention (SIP) Collaborative, through the sponsorship of the Centers for Medicare & Medicaid Services (CMS), achieved impressive results in reducing infection. SIP brought together hospital teams and quality improvement organizations (QIOs) from across the US who learned the
Breakthrough Series methodology from IHI.
One of the best-performing teams, Mercy Health Center in Oklahoma City, reduced post-surgery infections by 78 percent in one year by redesigning systems of care, says Dr. Mark Johnson, chief medical officer at Mercy. While Mercy’s SSI rates were low at the start of the project, Mercy was committed to reducing infections to the lowest achievable rate.
Mercy’s “Ounce of Prevention” team included representatives from multiple disciplines. Using the IHI rapid cycle model to test and implement changes, the team oversaw implementation of standardized processes such as improving the use of prophylactic antibiotics prior to surgery, maintaining normal body temperature for patients during surgery, and clipping rather than shaving the surgical site to reduce the risk of small nicks in the skin.
“There has to be a team effort to put these measures in place,” says Ronda Pasley-Shaw, RN, Mercy’s infection control practitioner and day-to-day project leader. “We had to educate everyone about using clippers. We had to work out the right timing and selection of each antibiotic, and identify who is responsible for hanging and monitoring it. Everyone needed to agree that keeping the operating room warmer is best for the patients, even though it gets quite warm for the rest of the surgical team.”
These efforts are clearly paying off. “We have had nearly 500 surgical cases in the pilot population without an SSI,” says Johnson.
