A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association

New Evidence-Based Strategies to Reduce Colon SSIMarch 2017

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Agenda

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Topic Speaker

Welcome and Introductions NYSPFP Staff

SSI Rates In NYS and Implementation of the NYSPFP Advanced Bundle Across NYS

NYSPFP Staff

Colorectal Surgery SSI: A Model for Outcomes Improvement

Christopher Mantyh, MD,FACS/FASCRSProfessor of Surgery Duke University Medical Center

Hospital Questions and Discussion Hospital Participants NYSPFP Staff

Next Steps NYSPFP Staff

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Why Focus on Surgical Site Infections?

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• 2.6% of 30 million operations per year are complicated by SSI (800,000 – 2 million SSI annually)

• SSI accounts for 38% of HAI in surgical patients• Colorectal surgery SSI rate varies between 5% to 30% • SSIs are associated with:

• Increased length of stay • Increased hospital costs (estimated increase of $1,300 –

$5,000 per case)• Increased patient morbidity and mortality • Increased readmission rates

References: 1. Boyce JM, Potter-Bynoe G, Dziobek L. Infect Conrol Hosp Epidemiol. 1990; 11(2):89-932. Poulson KB, Bremmelgaard A, Sorensen AI, Raahave D, Petersen JV. Epidemiol Ifect. 1994; 113(2); 283-2953. Martone WJ, Jarvis, WR, Culver DH, Haley RW, Bennet JV, Brachman PS, eds. Hospital Infections. 3rd ed. Little, Brown & Co. 1992:577-5964. Vegas, AA, Jodra VM, Garcia ML. Eur J Epidemiol. 1993;9(5):504-5105. Murray BW, Huerta S, Dineen S, Anthony T. J Am Coll Surg 2010;211(6):812-822

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Process Measures Survey

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NYSPFP SSI SIR: CABG

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Baseline 1/15 – 12/15: 0.97Comparison 8/16 – 10/16: 0.66Percentage improvement: 32.22%

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NYSPFP SSI SIR: Hip Replacement

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Baseline 1/15 – 12/15: 1.10Comparison 8/16 – 10/16: 0.95Percentage improvement: 14.13%

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NYSPFP SSI SIR: Hysterectomy

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Baseline 1/15 – 12/15: 1.12Comparison 8/16 – 10/16: 0.88Percentage improvement: 22.03%

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NYSPFP SSI SIR: Colon

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Baseline 1/15 – 12/15: 1.16Comparison 8/16 – 10/16: 0.94Percentage improvement: 18.67%

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NYSPFP SSI Rate: Colon

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Baseline 1/15 – 12/15: 7.17Comparison 8/16 – 10/16: 5.95Percentage improvement: 16.95%

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Advanced Colon Bundle Surgery Elements

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Surgery Bundle Elements Applicable Across Other Surgical Service Lines

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Implementing a Colon Bundle to Reduce SSI Christopher Mantyh, MD FACS/FASCRSDuke University Medical Center

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NYSPFP Tools to Support Advanced Bundle Implementation

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Flowchart is available for download from https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/SSI/Tools

.aspx

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Bundle Summary Table is available for download from https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/SSI/Tools

.aspx15

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Tools and Resources on NYSPFP Website

19 https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/SSI/Tools.aspx

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OR Observation Tool: Analytical Tool –

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Next Steps • Contact your project manager to discuss:

• Accessing the materials on the NYSPFP website • Completing/repeating Gap Analysis with Companion

Document to guide next steps • With a focus on implementing mechanical bowel prophylaxis in

combination with oral antibiotics• Consider using the OR observation tool • Hardwiring the advanced colon bundle elements into

workflow