Breaking News
September 25, 2018 - Hybrid theranostic complex shows high therapeutic efficacy against tumor cells
September 25, 2018 - FDA Issues Statement Reaffirming the Positive Benefit-Risk Profile of Nuplazid (pimavanserin) for Patients with Hallucinations and Delusions Associated with Parkinson’s Disease Psychosis
September 25, 2018 - 5 obstacles parents commonly face in child obesity treatment and how to overcome them
September 25, 2018 - Immunologist to study how Chikungunya causes devastating effects in older adults
September 25, 2018 - Rural borderland communities vulnerable to high stress impacting mental and physical health
September 25, 2018 - SNMMI announces recipients of 2018-2020 Wagner-Torizuka Fellowship
September 25, 2018 - Common painkiller not effective in controlling chronic pain after traumatic nerve injury
September 25, 2018 - New therapeutic vaccine helps immune cells fight HPV-related head and neck cancer
September 25, 2018 - Environmentally-induced gene activity influences IQ test performance
September 25, 2018 - Biogen and Eisai announce results of LTE Phase 1b study of aducanumab for treating MCI
September 25, 2018 - FDA Approves Copiktra (duvelisib) Capsules for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Follicular Lymphoma
September 25, 2018 - Medical device company settles US case over false claims
September 25, 2018 - Trying to get answers: One woman’s quest for a diagnosis
September 25, 2018 - Lung cancer patients treated with invasive surgery more likely to become chronic opioid users
September 25, 2018 - Oxford VR raises £3.2m to boost innovation in VR for mental health problems
September 25, 2018 - Gene therapy approach could help treat mitochondrial diseases
September 25, 2018 - Few Yogurt Products Qualify As Low-Sugar
September 25, 2018 - Eye disease can cause blindness, and it’s on the rise
September 25, 2018 - Pawnshop density linked to gun-related suicides, Stanford study finds
September 25, 2018 - Pioneering procedure for common prostate condition offered by The London Clinic
September 25, 2018 - Number of people with respiratory diseases likely to increase if UK air pollution remains unchecked
September 25, 2018 - FARXIGA receives positive results in Phase III DECLARE-TIMI 58 cardiovascular outcomes trial
September 25, 2018 - New program to reduce harmful stress effectively improves mood in cancer patients
September 24, 2018 - Florence’s Lingering Threat: Mold – Drugs.com MedNews
September 24, 2018 - For professional baseball players, faster hand-eye coordination linked to batting performance
September 24, 2018 - Bill for later school start times is defeated, but Stanford sleep specialist isn’t
September 24, 2018 - For Heart Failure Patients, Mitral Valve Procedure Improved Outcomes
September 24, 2018 - Successful recovery from addiction means more than achieving abstinence
September 24, 2018 - New nanoplatform technology may reverse drug-resistance in renal cell carcinoma
September 24, 2018 - October 1918 marks the centenary of Spanish Flu that claimed more lives than World War I
September 24, 2018 - LGBT community reports more number of poor mental health days than general population
September 24, 2018 - New research suggests power of zebrafish as tool for cancer drug discovery
September 24, 2018 - New study finds height as possible risk factor for developing varicose veins
September 24, 2018 - Researchers compare weight loss results of online and in-person diabetes prevention program
September 24, 2018 - New HER2 PET Study Uses Affibody’s ABY-025 Tracer to Individualize Breast Cancer Treatment
September 24, 2018 - Drug combination offers more effective care for patients suffering miscarriage
September 24, 2018 - Tallness linked to varicose veins, Stanford study says
September 24, 2018 - For Heart Failure Patients, Mitral Valve Procedure Improved Outcomes
September 24, 2018 - Ecstasy drug makes octopuses more social
September 24, 2018 - Immediate compression therapy could cut risk of complications after deep-vein thrombosis
September 24, 2018 - Transcatheter mitral valve repair reduces mortality for patients with mitral regurgitation
September 24, 2018 - First intracranial aneurysm patients treated with BRAVO Flow Diverter after CE mark approval
September 24, 2018 - ‘Physicians of the mouth’? Dentists absorb the medical billing drill
September 24, 2018 - People more likely to believe those with confident tone of voice than with accent
September 24, 2018 - Harmony Biosciences Presents 5-Year Data On Pitolisant At International Narcolepsy Symposium
September 24, 2018 - Blood test may identify gestational diabetes risk in first trimester
September 24, 2018 - Height may be risk factor for varicose veins | News Center
September 24, 2018 - King’s commemorates opening of new NMR facility with one-day symposium
September 24, 2018 - Eisai receives approval for partial label change of DC Bead device for transcatheter arterial embolization
September 24, 2018 - Using multi-level approach to reduce underage drinking among youths on rural reservations
September 24, 2018 - High-resolution genomic map gives scientists unprecedented view of brain development
September 24, 2018 - Researchers find impact of neurobehavioral symptoms on employment in adults with TBI
September 24, 2018 - Alexion announces positive results from Phase 3 PREVENT study of Soliris in patients with NMOSD
September 24, 2018 - First evaluation of benefits, harms of Alzheimer’s screening for family members of older adults
September 24, 2018 - Ancora Heart announces positive data of study evaluating AccuCinch Ventricular Repair System
September 24, 2018 - Children of mothers using cannabis may start using it at an earlier age, finds study
September 24, 2018 - Gilead Sciences plans to launch authorized generic versions of Epclusa and Harvoni in the US
September 24, 2018 - Most patients who underwent transcatheter valve replacement experience prosthesis-patient mismatch
September 24, 2018 - Lumos acquires license for LUM-201 drug that promotes secretion of growth hormone
September 24, 2018 - New study provides basis for Air Canada to change its facial hair policy for aircrew
September 24, 2018 - Infant walkers lead to thousands of emergency visits for babies
September 24, 2018 - Genes predicting person’s height may provide clues about causes of varicose veins
September 24, 2018 - EPA Plan Will Maintain Carbon Emissions From Power Plants
September 24, 2018 - Characterizing pig hippocampus could improve translational neuroscience
September 24, 2018 - Element3 Health reports social and mental engagement play key role in overall health
September 24, 2018 - Paralympic medalists support Fight for Sight’s unique virtual event
September 24, 2018 - ADCETRIS drug receives approval in Japan as frontline treatment option for Hodgkin lymphoma
September 24, 2018 - Public awareness of urological conditions found to be alarmingly low across Europe
September 24, 2018 - Fitter Folks Suffer Milder Strokes: Study
September 24, 2018 - Novel botulinum toxin compound relieves chronic pain
September 24, 2018 - CHMP recommends approval of Gilenya for treatment of multiple sclerosis in children, adolescents
September 24, 2018 - National Friendly’s private medical insurance is a hit with women living in the South East
September 24, 2018 - Academics receive prestigious awards for achievements in blood pressure research
September 24, 2018 - Obese pregnant women can restrict weight gain safely with proper nutrition guidance
September 24, 2018 - CHMP adopts positive opinion of Takeda’s ALUNBRIG for treatment of ALK+ non-small cell lung cancer
September 24, 2018 - China NMPA approves LENVIMA for treatment of unresectable hepatocellular carcinoma
September 24, 2018 - A new approach for finding Alzheimer’s treatments
September 24, 2018 - USC research uncovers previously unknown genetic risk factor for dementia
September 24, 2018 - Study examining mental health among students finds significant disparities in treatment across race
September 24, 2018 - Breakthrough discovery paves way for future test to identify drowsy drivers
Safety program successfully reduces SSIs in patients undergoing colorectal operations

Safety program successfully reduces SSIs in patients undergoing colorectal operations

image_pdfDownload PDFimage_print

Surgical site infections (SSIs) in patients undergoing colorectal operations were reduced by 61 percent in less than two years in Hawaiian hospitals participating in the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Surgery, according to new study findings published as an “article in press” on the website of the Journal of the American College of Surgeons ahead of print.

Despite widespread efforts to rein in SSIs, this postoperative complication remains common, accounting for about 20 percent of hospital-acquired infections, according to the Centers for Disease Control and Prevention. Infection of the surgical site prolongs hospital stays, raises health care costs, and increases risk of serious illness and death.

“It’s a major problem because half of the patients in our hospitals have an operation, putting them at risk for infection afterwards,” said study coauthor Julius Cuong Pham, MD, PhD, an associate professor at Johns Hopkins University School of Medicine, Baltimore, and a patient safety officer at The Queens Medical Center, Honolulu, Hawaii. “And a colorectal operation is a procedure with one of the highest rates of surgical site infection.”

To help address this issue, researchers from Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore; University of Hawaii, Honolulu; and University of California, San Francisco evaluated the effectiveness of AHRQ’s Safety Program for Surgery in all hospitals across Hawaii, the first time the program has been implemented at a state level.

This 15-hospital collaborative was part of a larger AHRQ-funded effort to improve surgical care nationwide. Between January 2013 and June 2015, health care teams in hospitals across Hawaii implemented AHRQ’s Comprehensive Unit-based Safety Program (CUSP), as well as their own customized interventions. CUSP is an innovative program that uses feedback from frontline providers to improve surgical teamwork and patient safety.

The study’s aim was to reduce colorectal SSIs and improve hospital safety culture. Multiple clinical interventions were implemented, specifically chlorhexidine wash before procedures, proper use of appropriate antibiotics, and standardized post-surgical debriefing. Non-technical skills for improving the safety culture involved better communication, teamwork, and decision-making strategies.

Two years after the start of the project, researchers found that the colorectal SSI rate for the collaborative decreased from 12.08 percent to 4.63 percent. The 61.7 percent reduction in colorectal SSIs seen is the greatest state-level reduction reported, the study authors noted.

“With this collaborative, we created a platform that allowed diverse types of hospitals to come together and accelerate learning and change,” said lead study author Della M. Lin, MD, MS, an anesthesiologist in the department of surgery, University of Hawaii. “By not working in silos, we were able to accelerate the reduction in surgical site infections faster and perhaps more effectively than hospitals could do by themselves.”

At the same time, safety culture improved in 10 of 12 categories, as measured by the AHRQ Hospital Survey on Patient Safety Culture. Areas of improvement included teamwork across units, communication-openness, and overall perception of patient safety.

Nationally, AHRQ’s survey tool showed (in 359 hospitals) the average change across these 12 patient safety culture domains was one percentage point between 2012 and 2014. In this collaborative, however, the average score across the 12 categories improved by more than five percentage points.

This outcome is significant because changes in safety culture, especially using AHRQ’s survey tool, are not common, and especially in the perioperative area, according to Dr. Pham.

The research is important for several reasons. This study highlights the fact that this program can be scaled up to a state level and likely to a health system level, according to Dr. Pham. “We already know that one or two hospitals can succeed at changing their safety culture. But it has never been done on a state level before.”

Additionally, the results are durable. “Since the Hawaii collaborative has ended, the infection rates are continuing to stay at these low rates, so that gives us some satisfaction knowing that there is sustainability in these remarkable results,” Dr. Lin said.

“Instead of working in isolation, we are creating a space for all hospitals within the state to leverage not just the national work but also each other for more powerful results,” Dr. Lin said. “This study is unique because it demonstrates how teams actually can get better ideas and results by synthesizing and harvesting the work together. The Hawaii collaborative continues as Hawaii Safer Care, applying what we’ve learned to future projects such as enhanced recovery after surgery protocols.”

The American College of Surgeons, in collaboration with the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, established the AHRQ Safety Program for Improving Surgical Care and Recovery (ISCR) in 2017.

“Collaboratives are a great opportunity for shared experiences and learning, and have been repeatedly shown to be effective in improving care and outcomes in the surgical realm,” said Clifford Y. Ko, MD, MHS, FACS, who is not a study author, but serves as the Director of Research and Optimal Patient Care at the American College of Surgeons. “In point of fact, the American College of Surgeons recently released the Optimal Resources for Surgical Quality and Safety, also known as the ‘Redbook,’ in which an entire chapter is devoted to the lessons learned from some of the leading collaboratives in surgery. The work done amongst these Hawaiian hospitals is another shining example of a successful collaborative,” he said.

Tagged with:

About author

Related Articles