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
1
NYS PARTNERSHIP FOR PATIENTS
Agenda
2
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
NYS PARTNERSHIP FOR PATIENTS
Why Focus on Surgical Site Infections?
3
• 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
NYS PARTNERSHIP FOR PATIENTS
Process Measures Survey
4
NYS PARTNERSHIP FOR PATIENTS
NYSPFP SSI SIR: CABG
5
Baseline 1/15 – 12/15: 0.97Comparison 8/16 – 10/16: 0.66Percentage improvement: 32.22%
NYS PARTNERSHIP FOR PATIENTS
NYSPFP SSI SIR: Hip Replacement
6
Baseline 1/15 – 12/15: 1.10Comparison 8/16 – 10/16: 0.95Percentage improvement: 14.13%
NYS PARTNERSHIP FOR PATIENTS
NYSPFP SSI SIR: Hysterectomy
7
Baseline 1/15 – 12/15: 1.12Comparison 8/16 – 10/16: 0.88Percentage improvement: 22.03%
NYS PARTNERSHIP FOR PATIENTS
NYSPFP SSI SIR: Colon
8
Baseline 1/15 – 12/15: 1.16Comparison 8/16 – 10/16: 0.94Percentage improvement: 18.67%
NYS PARTNERSHIP FOR PATIENTS
NYSPFP SSI Rate: Colon
9
Baseline 1/15 – 12/15: 7.17Comparison 8/16 – 10/16: 5.95Percentage improvement: 16.95%
NYS PARTNERSHIP FOR PATIENTS
Advanced Colon Bundle Surgery Elements
10
NYS PARTNERSHIP FOR PATIENTS
Surgery Bundle Elements Applicable Across Other Surgical Service Lines
11
Implementing a Colon Bundle to Reduce SSI Christopher Mantyh, MD FACS/FASCRSDuke University Medical Center
12
NYSPFP Tools to Support Advanced Bundle Implementation
13
NYS PARTNERSHIP FOR PATIENTS
.
Flowchart is available for download from https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/SSI/Tools
.aspx
NYS PARTNERSHIP FOR PATIENTS
.
Bundle Summary Table is available for download from https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/SSI/Tools
.aspx15
NYS PARTNERSHIP FOR PATIENTS
.
NYS PARTNERSHIP FOR PATIENTS
.
17
NYS PARTNERSHIP FOR PATIENTS
18
NYS PARTNERSHIP FOR PATIENTS
Tools and Resources on NYSPFP Website
19 https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/SSI/Tools.aspx
NYS PARTNERSHIP FOR PATIENTS
OR Observation Tool: Analytical Tool –
20
NYS PARTNERSHIP FOR PATIENTS
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