Oscar Guillamondegui, MD, MPH, FACS Associate Professor of Surgery Tennessee Surgical Quality Collaborative
|
|
- Sharleen Caldwell
- 5 years ago
- Views:
Transcription
1 Oscar Guillamondegui, MD, MPH, FACS Associate Professor of Surgery Tennessee Surgical Quality Collaborative
2 NSQIP 2014 A Collaborative that has Reduced Surgical Site Infections Tennessee Surgical Quality Collaborative Oscar Guillamondegui, MD, MPH Vanderbilt University Medical Center *Guillamondegui, OD, et al. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. J Am Coll Surg. April 2012;
3 Disclosures: I have nothing to disclose *Guillamondegui, OD, et al. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. J Am Coll Surg. April 2012;
4 TSQC Mission To improve the care of the surgical patient by supporting an open discussion and transfer of information through a collaborative team effort. Vision To identify best surgical practices, examine how the surgical team obtains best outcomes and teach other surgical teams how to improve outcomes.
5 Post-Op Occurrence Results Post-Op Complications* (Savings/10,000 Procedures) Unit Costs NSQIP ROI Net Savings Per 10,000 Acute Renal Failure Graft/Flap Failure On Vent> 48 hours Superficial Incisional SSI (-25%) $28,359 $535, (-60%) $14,851 $411, (-15%) $27,654 $1,197, (-19%) $27,631 $1,870,619 Wound Disruption (-34%) $14,827 $461,120 Total 2010 Savings $4,476,515 *Guillamondegui, OD, et al. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. J Am Coll Surg. April 2012;
6 Post-Op Occurrence Results Post-Op Complications* (Savings/10,000 Procedures) Unit Costs NSQIP ROI Net Savings Per 10,000 Acute Renal Failure Graft/Flap Failure On Vent> 48 hours Superficial Incisional SSI (-25%) $28,359 $535, (-60%) $14,851 $411, (-15%) $27,654 $1,197, (-19%) $27,631 $1,870,619 Wound Disruption (-34%) $14,827 $461,120 Total 2010 Savings $4,476,515 *Guillamondegui, OD, et al. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. J Am Coll Surg. April 2012;
7 Costs of Surgical Site Infections Literature review LOS increases 7-10 days Additional cost $20,000 THA* hospital billing data TSQC Patients with wound occurrence Average length of stay 7.2 extra days Additional costs $25,546 per case THA: Tennessee Hospital Association
8
9 Justification for Colectomy Focus High volume in all hospitals 8-9% of total TSQC cases 1250 colon cases (using our CPT groups) on average/year for the TSQC - Performed by large percentage of surgeons 188 different surgeon ID s Practice recommendations available Established outcomes rates NSQIP NHSN
10 Identifying a bundle No structured, recognized group of strategies to reduce risk of SSI Some data for specific interventions and practices, none for a group of practices. Some approaches have generated controversy SCIP Mechanical and antibiotic bowel preparation Hyperoxygenation
11 TSQC Requirements Level 1 or 2 data Not inflammatory to the surgeons Consider elements already in place (e.g., SCIP) Easily implemented case by case Able to be abstracted from the medical record Not mutually dependent: hospitals and surgeons can choose to participate in any or all of the elements Cheap
12 Bundle Options Oral antibiotics Skin prep prior to admission Glycemic Control Parenteral Antibiotics Mechanical Bowel prep Perioperative oxygenation Wound protection Anastomosis technique NORMOTHERMIA Skin prep prior to incision
13 The TSQC Colorectal Bundle Normothermia Glucose Control Appropriate antibiotic use Supplemental Fi02
14 Oxygenation Normothermia Glucose Control Antimicrobial prophylaxis ColectomyBundle Recommendation Evidence Summary Resource Summary Findings Comments A bundle of interventions to Implementation of Colorectal surgical site infection Small sample size reduce colorectal surgical Normothermia infections Normoglycemia Bull A, et al Oxygen delivery Appropriate antibiotics 15% > 7% (not statistically significant Difficulty to implement and maintain; low compliance with individual components Infection rates fell over the subsequent 12 months. Perioperative supplemental oxygen therapy and surgical site infection: a meta-analysis of randomized controlled trials Qadan M et al Perioperative Normothermia to reduce the incidence of surgical wound infection and shorten hospitalization Kurz et al Scientific Principles and Clinical Implications of Perioperative Glucose regulation and control Akhtar, S et al Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project Bratzler DW et al Meta-analysis 5 RCTs Control FiO ; Study FiO2.80 for 2-6 hours postoperatively 30 day follow up 3 studies colorectal; 2 studies multispecialty Double-blind RCT demonstrating triple the incidence of SSI and pronged hospitalization in patients undergoing colectomy with intraoperative hypothermia Review article evaluating glucose control in the preoperative, intraoperative, and postoperative periods Consensus position statement from the Surgical Infection Prevention Guidelines Writers Group Surgical site infection rates 12% control; 9% hyperoxic. Relative risk reduction Greater benefit in colorectal procedures Surgical site infection in 19% of patients with intraoperative hypothermia and 6% of patients with intraoperative normothemia. Though there are unresolved questions regarding appropriate control it is prudent to maintain glucose levels < 180 mg / dl Optimal prophylaxis ensures that adequate concentrations of an appropriate antimicrobial are present in the serum, tissue, and wound during the entire time that the incision is open and at risk for bacterial contamination. Variable use of abx, blood loss among studies No standard definition of infection Significant improvement in all but one study, where SSI rate increased. Standard preoperative prep; cases riskadjusted for smoking, BMI, wound class, length of surgery. Clinical diagnosis of SSI. The authors site heterogeneity in many of the included studies as a limitation to the analysis; postoperative control appears to have the most significant effect on postoperative complications This article is a primary source document for SCIP guidelines
15 Clinical Application and Review Measure Recommendation Clinical Application NSQIP Abstraction Normothermia Maintain core temperature >36 during the perioperative period Check temperature prior to entering the operating room. Check every 15 minutes intraoperatively. Check immediately upon arrival in PACU and every 30 minutes until discharge from PACU. Active warming (e.g., Bair hugger) for patients with temp < 36. Abstract lowest intraoperative temperature. Normoglycemia Maintain blood glucose level < 200 mg/dl on the day of surgery and through the postoperative period Check blood glucose (all patients) prior to entering the operating room, and in the PACU. Institute sliding scale insulin coverage for blood glucose > 200, or per hospital protocol. Abstract the highest glucose on the day of surgery. Antibiotic use Appropriate antibiotic selection and timing per SCIP guidelines Administer antibiotics within 1 hour prior to surgical incision. Redose antibiotics if appropriate for operations lasting 3 hours or more. No abstraction; hospital will report SCIP Inf 1f, 2f, and 3f performance. Supplemental Oxygen Administer supplemental oxygen at 80% intraoperatively and postoperatively Deliver FiO 2.80 through the anesthesia circuit and postoperatively for 6 hours by nonrebreather. Review anesthesia record, postoperative order set, PACU record for intraop and postop delivery. Answer yes if the order is for FiO2.80. Answer yes if there is documentation that the patient received oxygen at.80. If there is no order, and no documentation of FiO2.80, answer no
16 Collaborative Implementation Fall 2011 Baseline data analysis Literature review and development of recommendations Leadership Committee review and approval Consensus approval from collaborative membership Winter Collaborative implementation target: January 1 Trial implementation by Dr. Gibson SCR review and refinement of custom fields
17 Collaborative Implementation Spring 2012 Review of implementation progress: limited to individual surgeon preference in 6 of 10 hospitals Evaluation of support needs from members 10 Tennessee hospitals join NSQIP and TSQC Summer 2012 Status review with each hospital Early analysis of custom field utilization
18 Colon Bundle Update Total TSQC Cases 80,207 Cases w/glucose 26,745 Cases w/temp 28,119 Cases w/fio2 3,362 Total Colectomies 6,862 Colectomies w/glucose 2,711 Colectomies w/temp 2,849 Colectomies w/fio2 659 Colectomies w/all Total Colectomies 6,862 Colectomies w/all 3 credible values 379 Of the 379 Cases w/ all 3 values in the credible range Measure Mean/SD Criterion Cases < criterion Cases > criterion Glucose 161.9/ % 32.5% Temperature 96.9/ F 41.4% 58.6% This information is prepared and protected in accordance with the Tennessee Patient Safety and Quality Improvement Act of T.C.A
19 SSI Rates Year Total Cases Deep SSI Organ SSI Superficial SSI ALL SSI WD Total Year Total Cases Deep SSI Organ SSI Superficial SSI ALL SSI WD % 1.5% 3.4% 5.7% 0.8% % 1.7% 2.8% 5.2% 0.6% % 1.3% 2.7% 4.5% 0.4% % 1.0% 2.1% 3.7% 0.7% % 0.9% 2.1% 3.7% 0.6% Total % 1.3% 2.6% 4.5% 0.6% This information is prepared and protected in accordance with the Tennessee Patient Safety and Quality Improvement Act of T.C.A
20 SSI Rates Year Total Cases Deep SSI Organ SSI Superficial SSI ALL SSI WD Total Year Total Cases Deep SSI Organ SSI Superficial SSI ALL SSI WD % 1.5% 3.4% 5.7% 0.8% % 1.7% 2.8% 5.2% 0.6% % 1.3% 2.7% 4.5% 0.4% % 1.0% 2.1% 3.7% 0.7% % 0.9% 2.1% 3.7% 0.6% Total % 1.3% 2.6% 4.5% 0.6% This information is prepared and protected in accordance with the Tennessee Patient Safety and Quality Improvement Act of T.C.A
21 Colectomy Operative Time v. All SSI Rate Decile Rank of Operative Time Operative Total SSI Cases Time (Hours) Rate (%) % % % % % % % % % %
22 Colectomy Operative Time v. All SSI Rate Decile Rank of Operative Time Operative Total SSI Cases Time (Hours) Rate (%) % % % % % % % % % %
23 NSQIP 2014 A Collaborative that has Reduced Surgical Site Infections Tennessee Surgical Quality Collaborative Oscar Guillamondegui, MD, MPH Vanderbilt University Medical Center *Guillamondegui, OD, et al. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. J Am Coll Surg. April 2012;
24 Oscar Guillamondegui, MD, MPH, FACS Associate Professor of Surgery Tennessee Surgical Quality Collaborative
Clinical Standardization
Clinical Standardization Joe Sharma, MD, FACS, FACE Associate Professor of Surgery Director, of Endocrine Surgery Chief Quality Officer Emory University School of Medicine Disclosures Engineer US Navy
More informationColorectal Pathway: A Template for the Georgia Surgical Quality Collaborative
Colorectal Pathway: A Template for the Georgia Surgical Quality Collaborative Disclosure Bryant Wilson, MD Relevant Financial Relationships: I have no actual or potential conflict of interest in relation
More informationPreventing Surgical Site Infections: Implementing a Multidisciplinary Evidence-Based Strategy
Preventing Surgical Site Infections: Implementing a Multidisciplinary Evidence-Based Strategy Cindy Kildgore, RN, BSN, MSHA, CNOR Perioperative Services VOR Director Vanderbilt University Medical Center,
More informationStrategy/Driver Prevention Strategies Action Strategies
I. Hospital executive leadership commitment to prevention of surgical site infections 1. Establish Surgical Site Infection prevention as a strategic priority 2. Develop and implement business/strategic
More informationWhich Elements in a Wound Infection Prevention Process are Important? Aaron Chen, BS, Sebastian Perez, MSPH, John Sweeney, MD, Joe Sharma, MD
Which Elements in a Wound Infection Prevention Process are Important? Aaron Chen, BS, Sebastian Perez, MSPH, John Sweeney, MD, Joe Sharma, MD Disclosure Slide No COI and no disclosures. SSI Surgical Site
More informationA System-Based Approach to Colorectal Surgery SSI Reduction: Interventions Across the Episode of Care
A System-Based Approach to Colorectal Surgery SSI Reduction: Interventions Across the Episode of Care Robert R. Cima, MD, MA Minnesota SSI Reduction Effort December 2013 2011 MFMER slide-1 Attestation
More informationEnhanced Recovery in NSQIP (ERIN): an update on the collaborative. Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015
Enhanced Recovery in NSQIP (ERIN): an update on the collaborative Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015 No disclosures ERIN, ERAS, and ERP ERIN-Enhanced Recovery
More informationNational Priorities for Improvement:
National Priorities for Improvement: Standardization of Performance Measures, Data Collection, and Analysis Dale W. Bratzler, DO, MPH Principal Clinical Coordinator Oklahoma Foundation Contracting for
More informationEffect of Colon Bundle Implementation in a Community Hospital. Michael Barringer, MD, FACS CHS Cleveland
Effect of Colon Bundle Implementation in a Community Hospital Michael Barringer, MD, FACS CHS Cleveland Doug Hobson, MD, Surgeon Champion Mike Barringer, MD, Surgeon Champion No Disclosures Except for
More informationReliability of Evaluating Hospital Quality by Surgical Site Infection Type. ACS NSQIP Conference July 22, 2012
Reliability of Evaluating Hospital Quality by Surgical Site Infection Type ACS NSQIP Conference July, 01 Surgical Site Infection Common cause of patient morbidity 5%-6% for colorectal procedures Significant
More informationCanadian Surgical Site Infection Prevention Audit Month
Canadian Surgical Site Infection Prevention Audit Month February 2016 CONTENTS KEY FACTS...3 SSI PREVENTION AUDIT RESULTS...3 BACKGROUND...4 METHODOLOGY...4 Data Scores... 5 How to Interpret the Indicator
More information1/10/2012. Objectives. Normothermia as a SSI Reduction Tool. Disclosure. Darin Prescott, MSN, MBA, RN,BC, CNOR, CASC
Normothermia as a SSI Reduction Tool Darin Prescott, MSN, MBA, RN,BC, CNOR, CASC Disclosure Arizant Healthcare Inc., a 3M company Objectives Describe the impact of hypothermia on perioperative patient
More information9/29/2017. Enhanced Recovery After Surgery at the University of Virginia Medical Center. Disclosures. Objectives. None
Enhanced Recovery After Surgery at the University of Virginia Medical Center Bethany Sarosiek, RN, MSN, MPH, CNL University of Virginia Health System Charlottesville, VA ErasRN@virginia.edu Disclosures
More informationQuality Improvement Initiative (QII): 2018 Options
Quality Improvement Implementation, Option A: Increase Surgeon Engagement Outcome Measure: SSI Summary: Surgeon Engagement is essential for the success of quality improvement programs within hospitals.
More informationEffectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery
COLORECTAL SURGERY Ann R Coll Surg Engl 2016; 98: 270 274 doi 10.1308/rcsann.2016.0072 Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery J Tanner
More informationThe Joint Commission and Cleveland Clinic Reducing Colorectal Surgical Site Infections
The Joint Commission and Cleveland Clinic Reducing Colorectal Surgical Site Infections Cleveland Clinic Experience for NSQIP Conference Guido Bergomi 26 July, 2014 Mission Dr. Frank E. Bunts Dr. George
More informationEnhanced Recovery Implementing Meaningful Change
Enhanced Recovery Implementing Meaningful Change Jeff Simmons MD Associate Professor UAB Department of Anesthesiology and Perioperative Medicine I have no relevant financial relationships to disclose.
More informationWhat s next? Joint Commission Center for Transforming Healthcare Colorectal Surgical Site Infections (SSIs) Copyright, The Joint Commission
What s next? Joint Commission for Transforming Healthcare Colorectal Surgical Site Infections (SSIs) 1 Public Launch SSI Storyboard 2 COLORECTAL SURGICAL SITE INFECTIONS: CHARACTERISTICS OF THE PROJECT
More informationPerioperative Surgical Home
None Disclosures Debnath Chatterjee, M.D. Associate Professor of Anesthesiology CRASH 2015 - Vail, Colorado 2 Learning Objectives What is the PSH model? Describe the concept of the Perioperative Surgical
More informationCombined SSI Bundles and ERAS in Colorectal Surgeries
Combined SSI Bundles and ERAS in Colorectal Surgeries Joy Lanfranchi BSN, RN, CNOR, CMLSO Richard Bollin Jr. M.D. Kevin Kinzinger M.D. MBA, FACS, FASCRS Joanne Bonnot MSN, RN, BBA, NE-BC Claudia Skinner
More informationOrganizational Culture Change Results in Improvement in Outcomes, Value and Experience. Elizabeth C. Wick, M.D.
Organizational Culture Change Results in Improvement in Outcomes, Value and Experience Elizabeth C. Wick, M.D. Objectives To describe the burden and complexity of surgical site infections To outline the
More informationOver the past decade, the number of quality measurement programs has grown
Performance improvement Surgeon sees standardization and data as keys to higher value healthcare Over the past decade, the number of quality measurement programs has grown exponentially as hospitals respond
More informationReducing Surgical Site Infections in Colon Surgery Patients
Reducing Surgical Site Infections in Colon Surgery Patients Mercy Health St. Elizabeth Boardman Hospital A Catholic healthcare ministry serving Ohio and Kentucky Mercy Health St. Elizabeth Boardman Hospital
More informationThe dawn of hospital pay for quality has arrived. Hospitals have been reporting
Value-based purchasing SCIP measures to weigh in Medicare pay starting in 2013 The dawn of hospital pay for quality has arrived. Hospitals have been reporting Surgical Care Improvement Project (SCIP) measures
More informationThe How to Guide for Reducing Surgical Complications
The How to Guide for Reducing Surgical Complications Post operative wound (surgical site) infections Maintaining perioperative normothermia Main contacts for Reducing Surgical Complications Campaign Director:
More informationSCIP. Surgical Care Improvement Project. Making Surgeries Safer. By: Roshini Mathew, RN
SCIP Surgical Care Improvement Project Making Surgeries Safer By: Roshini Mathew, RN Importance Hospitals could prevent 13,000 patient deaths and 271,000 surgical complications each year 4 measures are
More informationNQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form
Last Updated: Version 3.2 NQF-ENORSE VOLUNTARY CONSENSUS STANARS FOR HOSPITAL CARE Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure I#: SCIP- Performance Measure
More informationSSI bundle reduces post-cesarean sections infections by 84% Infection Control Weekly Monitor, May 5, 2010
USE OF BUNDLE TO PREVENT SURGICAL SITE INFECTIONS IN COLORECTAL SURGERY: THE MODEL OF PIEMONTE HOSPITALS Massimiliano Caccetta, Pier Angelo Argentero*, Enzo Carlo Farina**, Silvia Romagnoli, Carla Maria
More informationImproving Compliance
Improving Compliance * The following planners, speakers, moderators, and/or panelists of this CME activity have no relevant financial relationships with commercial interests to disclose: Mary B. Johnson
More informationSurgical Site Infection (SSI) Road Map
Surgical Site Infection (SSI) Road Map MHA s road maps provide hospitals and health systems with evidence-based recommendations and standards for the development of topic-specific prevention and quality
More informationTeamwork, Communication, O.R. Safety & SSI Reduction
2011 Infection Prevention Leadership Teamwork, Communication, O.R. Safety & SSI Reduction Teamwork, Communication, O.R. Safety & SSI Reduction 2 Presented by: E. Patchen Dellinger, MD, FACS Professor of
More informationLANCASTER GENERAL HEALTH
Lori Abel RN, M.Ed. NO DISCLOSURES Penn Medicine Lancaster General Health LANCASTER GENERAL HEALTH Integrated Health System serving Lancaster Pennsylvania with a regional population ~1 million 631 licensed
More informationEP20EO Clinical nurses are involved in the review, action planning, and evaluation of patient safety data at the unit level.
Exemplary Professional Practice CULTURE OF SAFETY EP20EO Clinical nurses are involved in the review, action planning, and evaluation of patient safety data at the unit level. Example B: Provide one example,
More informationReduction of Surgical Site Infections in the Cesarean Section Patient through Incision Care
Problem: 1. Surgical site infections continued to remain higher than the NHSN (National Healthcare Safety Network) mean, despite implementation and compliance in all SCIP measures, up to and including
More informationHRET HIIN Surgical Site Infection (SSI) Guidance to Prevent Surgical Site Infections in the Era of Unresolved Issues June 29, 2017
HRET HIIN Surgical Site Infection (SSI) Guidance to Prevent Surgical Site Infections in the Era of Unresolved Issues June 29, 2017 1 WELCOME AND INTRODUCTIONS Elizabeth Ross, MPH, Program Manager HRET
More informationValue-based incentive payment percentage 3
Report Run Date: 07/12/2013 Hospital Value-Based Purchasing Value-Based Percentage Payment Summary Report Page 1 of 5 Percentage Summary Report Data as of 1 : 07/08/2013 Total Score Facility State National
More informationACS NSQIP Tools for Success. National Conference July 21, 2012
ACS NSQIP Tools for Success National Conference July 21, 2012 Current and Coming Tools Participant Use Data File (PUF) ROI Calculator Best Practices Guidelines Best Practices Case Studies Quality Improvement
More informationNOTE: New Hampshire rules, to
NOTE: New Hampshire rules, 309.01 to 309.08 Email Request: Selected Items in Table of Contents: (8) Time Of Request: Sunday, August 07, 2011 18:11:07 EST Send To: MEGADEAL, ACADEMIC UNIVERSE UNIVERSITY
More informationSSI/OR Safety Introductory Webinar. A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association
SSI/OR Safety Introductory Webinar A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association Agenda 2 Introduction to SSI/OR Safety Approach Zeynep Sumer
More informationENVIRONMENT Preoperative evaluation clinic. Preoperative evaluation clinic. Preoperative evaluation clinic. clinic. clinic. Preoperative evaluation
Goals and Objectives, Preoperative Evaluation Clinic Rotation, CA-1 and CA-2 year UCSD DEPARTMENT OF ANESTHESIOLOGY PREOPERATIVE EVALUATION CLINIC ROTATION GOALS AND OBJECTIVES, CA-1 and CA-2 YEAR PATIENT
More informationMeasure Abbreviation: TEMP 03 (MIPS 424)*
Measure Abbreviation: TEMP 03 (MIPS 424)* *TEMP 03 is built to the specification outlined by the Merit Based Incentive Program (MIPS) 424: Perioperative Temperature Management measure. MIPS measure specifications
More informationChallenges of Sustaining Momentum in Quality Improvement: Lessons from a Multidisciplinary Postoperative Pulmonary Care Program
Challenges of Sustaining Momentum in Quality Improvement: Lessons from a Multidisciplinary Postoperative Pulmonary Care Program Michael R Cassidy, MD Pamela Rosenkranz, RN, BSN, MEd, and David McAneny
More informationPost Discharge Surgical Site Infection Surveillance Made Easy Prof. Judith Tanner, De Montfort University, UK A Webber Training Teleclass
Post Discharge Surgical Site Infection Surveillance Made Easy Prof Judith Tanner, De Montfort University, UK Category Abdominal hyst Hip CABG Vascular Small bowel Large bowel Professor Judith Tanner De
More informationNoCVA SSI/VTE Safe Surgery Collaborative
NoCVA SSI/VTE Safe Surgery Collaborative Orientation Webinar #3 Measures and Data Collection July 19, 2012 Presented by: Jan Mangun, MT(ASCP), MSA, CPHRM Executive Director, Quality and Patient Safety
More informationMeasure Abbreviation: TEMP 03 (MIPS 424)*
Measure Abbreviation: TEMP 03 (MIPS 424)* *TEMP 03 is built to the specification outlined by the Merit Based Incentive Program (MIPS) 424: Perioperative Temperature Management measure. MIPS measure specifications
More informationAlthough surgical site infections (SSIs) occur infrequently. Implementation of a Pediatric Orthopaedic Bundle to Reduce Surgical Site Infections
Implementation of a Pediatric Orthopaedic Bundle to Reduce Surgical Site Infections 1.5 Contact Hours Jan Schriefer James Sanders Julie Michels Kori Wolcott Connor Ruddy Jenna Hanson Surgical site infections
More informationAre You Preventing Surgical Site Infections? No Outcome, No Income
Are You Preventing Surgical Site Infections? No Outcome, No Income Dale Bratzler, DO, MPH Kathy Haig, RN Frances Griffin, RRT, MPA Jennifer Dingman Hayley Burgess, PharmD Charles Denham, MD February 25,
More informationExpedition: Improving Safety and Reliability for Surgical Procedures
These presenters have nothing to disclose Expedition: Improving Safety and Reliability for Surgical Procedures Session 5 William Berry, MD, MPA, MPH, FACS Kathy Duncan, RN January 23, 2014 Expedition Coordinator
More informationTHE AMERICAN BOARD OF ANESTHESIOLOGY
THE AMERICAN BOARD OF ANESTHESIOLOGY 4208 Six Forks Road, Suite 1500 Raleigh, NC 27609-5765 Phone: (866) 999-7501 Fax: (866) 999-7503 Website: www.theaba.org MOCA PART 4: IMPROVEMENT IN MEDICAL PRACTICE
More informationOur SAR Looks Great, Now What? ACS NSQIP Pediatric
Our SAR Looks Great, Now What? ACS NSQIP Pediatric Jacqueline Saito, MD, MSCI, FACS St. Louis Children s Hospital Surgeon Champion ACS Children s Surgery Data Committee Vice Chair Disclosures I have no
More informationEnhanced Recovery After Surgery (ERAS) for Elective Colon Resection Surgery at Vancouver General Hospital. What is Possible?
Enhanced Recovery After Surgery (ERAS) for Elective Colon Resection Surgery at Vancouver General Hospital What is Possible? BC Provincial Collaborative November 25, 2014 Disclosure Statement I do not have
More informationUsing Your Hospitals Data for Research. Elizabeth C. Wick, MD
Using Your Hospitals Data for Research Elizabeth C. Wick, MD Disclosure I have no formal training in health services research We are not successful at securing resources 6: Wick EC, Hicks C, Bosk CL. Surgical
More informationACS NSQIP Tools for Success. Pre-Conference Session July 25, 2015
ACS NSQIP Tools for Success Pre-Conference Session July 25, 2015 No disclosures Disclosure Slide Collect the Data Continuous Quality Improvement Implement QI ACS NSQIP Analyze the Data Utilize Tools Current
More informationCarol J. Peden BSC, MB ChB, MD, FRCA, FFICM, MPH Royal United Hospital, Bath
Carol J. Peden BSC, MB ChB, MD, FRCA, FFICM, MPH Royal United Hospital, Bath Up to 25,000 surgical deaths per year 5-10% of surgical cases are high risk 79% of deaths occur in the high risk group Overall
More informationEnsuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment
Ensuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment Jeffry Peters, President Surgical Directions, LLC Joseph Bosco, MD Associate Professor;
More informationSCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf- 9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time 5
Release Notes: Alphabetical Data Dictionary Version 3.3 Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationObjectives. Integrating Performance Improvement with Publicly Reported Quality Metrics, Value-Based Purchasing Incentives and ISO 9001/9004
Integrating Performance Improvement with Publicly Reported Quality Metrics, Value-Based Purchasing Incentives and ISO 9001/9004 Session: C658 2013 ANCC National Magnet Conference Thursday, October 3, 2013
More information4/10/2013. Learning Objective. Quality-Based Payment Models
Creating Best in Class Perioperative Services under Accountable Care and Value- Based Purchasing Becker s Healthcare Jeffry Peters Learning Objective How ACA/VBP changes how we measure surgical services
More informationRisk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence
Risk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence Adam P. Johnson MD, MPH, Anisha Kshetrapal MD, Harold Hsu MD, Randi Altmark RN, BSN, Herbert E Cohn MD, FACS, Scott
More information2010 PQRI REPORTING OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY
Measure #193: Perioperative Temperature Management 2010 PQRI REPTING OPTIONS F INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of patients, regardless of age, undergoing surgical or therapeutic
More informationChinwe Nwosu, GE/NMF Scholar Supervisor: Dr. Stephen Ttendo, Senior Lecturer/ Head of Department of Anesthesia
Chinwe Nwosu, GE/NMF Scholar Supervisor: Dr. Stephen Ttendo, Senior Lecturer/ Head of Department of Anesthesia According to the Uganda Ministry of Health 2010 Clinical Guidelines Read the notes/ medical
More informationColorectal SSI Reduction and Collaboration with the Center for Transforming Healthcare
Colorectal SSI Reduction and Collaboration with the Center for Transforming Healthcare Lessons I Learned Robert R. Cima, MD 2012 ACS NSQIP National Conference July 22-24, 2012 2011 MFMER slide-1 Mayo Clinic,
More informationReliability of Superficial Surgical Site Infections as a Hospital Quality Measure
Reliability of Superficial Surgical Site Infections as a Hospital Quality Measure Lillian S Kao, MD, MS, FACS, Amir A Ghaferi, MD, MS, Clifford Y Ko, MD, MS, MSHS, FACS, Justin B Dimick, MD, MPH, FACS
More informationPatient Selection, Optimization and Disposition: Tools for Success in Orthopedic Bundles
Patient Selection, Optimization and Disposition: Tools for Success in Orthopedic Bundles Luann Tammany Tribus, PT, MBA SVP, Clinical Strategy & Innovation Remedy Partners John Kilgore, MD Orthopedic Surgeon
More informationSurgical Care Improvement Project
Safer Surgeries: Surgical Care Improvement Project Leslie N. Ray Ph.D., RN Oregon Patient Safety Commission Ruth Medak, MD Acumentra Health What is SCIP? National effort to decrease preventable surgical
More information? Prehab, immunonutrition. Safe surgical principles. Optimizing Preoperative Evaluation
Optimizing Preoperative Evaluation Timothy Geiger, MD, MMHC Associate Professor of Surgery Executive Medical Director, Surgery Patient Care Center Chief, Division of General Surgery Director, Colon and
More informationN ATIONAL Q UALITY F ORUM. Safe Practices for Better Healthcare 2006 Update A CONSENSUS REPORT
N ATIONAL Q UALITY F ORUM Safe Practices for Better Healthcare 2006 Update A CONSENSUS REPORT NATIONAL QUALITY FORUM Foreword Every person who seeks care in a healthcare facility should expect to receive
More informationPREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation
PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation Rowena Chona O. Sano, MSN, RN, CNL, CPHQ Memorial Hermann Greater Heights Hospital Houston, TX Nothing
More informationAHRQ Safety Program for Improving Surgical Care and Recovery. ACS Quality and Safety Conference New York City July 21, 2017
AHRQ Safety Program for Improving Surgical Care and Recovery ACS Quality and Safety Conference New York City July 21, 2017 1 Project goals To measurably improve patient outcomes in five surgical areas
More informationResearch from the Health Protection Agency
Changing wound care protocols to reduce postoperative caesarean section infection and readmission KEY WORDS Caesarean section Infection Diabetes Obesity PICO Opsite Post-Op Visible Due to concern centring
More informationScrubbing down on Surgical Site Infections: Decreasing the incidence of surgical site infections in children
Scrubbing down on Surgical Site Infections: Decreasing the incidence of surgical site infections in children Tiffany Trenda, DO PGY2, Jessie Allen, DO PGY2, Elizabeth Mack, MD MS, Chris Hydorn, MD, Lori
More informationPrevention of Orthopaedic Surgical Site Infections in the Perioperative Setting. Disclosures. Objectives
Prevention of Orthopaedic Surgical Site Infections in the Perioperative Setting Mary Atkinson Smith, DNP, FNP-BC, ONP-C, RNFA, CNOR & W. Todd Smith, MD, FAAOS Disclosures We hereby certify that, to the
More informationSurgical Site Infection Prevention: Guidelines, Recommendations and Best Practice
Surgical Site Infection Prevention: Guidelines, Recommendations and Best Practice Linda Goss BS, MSN, APN-BC, CIC, COHN-S Director, Infection Prevention and Control and Vascular Access Specialist Team
More information3 SCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf-9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time
Release Notes: Alphabetical Data Dictionary Version 3.0b Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationImproving Hospital Performance Through Clinical Integration
white paper Improving Hospital Performance Through Clinical Integration Rohit Uppal, MD President of Acute Hospital Medicine, TeamHealth In the typical hospital, most clinical service lines operate as
More informationEnhanced recovery after surgery: the role of the PACU & Pre-op
Enhanced recovery after surgery: the role of the PACU & Pre-op Magnus K. Teig BSc (Hons.) MBChB MRCP FRCA EDIC FFICM Assistant Professor Anesthesia & Neurosurgery Director UH PACU University of Michigan
More informationAMERICAN COLLEGE OF SURGEONS Inspiring Quality: Highest Standards, Better Outcomes
AMERICAN COLLEGE OF SURGEONS Inspiring Quality: Highest Standards, Better Outcomes SSI Measure Harmonization ACS NSQIP and CDC NHSN Bruce Lee Hall, MD, PhD, MBA, FACS 2012 ACS NSQIP National Conference
More informationPSI 12 - Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate Opportunity
MAY 2018 A MESSAGE FROM THE SAINT LUKE S CARE CMO Table of Contents PSI 12 - Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate Opportunity 1,2 NEW Order Sets & Documents 3 Saint Luke s Care
More informationActionable Patient Safety Solution (APSS) #2C: SURGICAL SITE INFECTIONS (SSI)
Actionable Patient Safety Solution (APSS) #2C: SURGICAL SITE INFECTIONS (SSI) Executive Summary Checklist In order to establish a program to reduce surgical site infections (SSIs) the following implementation
More informationUniversity of Washington Medical Center Approach: Using the NSQIP ROI Calculator to Demonstrate Medical Center Cost Savings
University of Washington Medical Center Approach: Using the NSQIP ROI Calculator to Demonstrate Medical Center Cost Savings E. Patchen Dellinger, MD Rosemary Mitchell Grant, RN, BSN, CPHQ Disclosures E.
More informationRecommendation II. Recommendation I. Who s on Your Team? Recommendation III
Infection Prevention In the Surgical Suite Janie Kinsey, RN, CASC Administrator, St. Luke s South Surgery Center President, Kansas Association of Ambulatory Surgery Centers Objectives Recommendation I
More informationUsing Evidence to Improve Outcomes for the Surgical Patient: Post-Operative Interventions
Using Evidence to Improve Outcomes for the Surgical Patient: Post-Operative Interventions January 16, 2014 1 A partnership of the Healthcare Association of New York State and the Greater New York Hospital
More informationINTERPRETING THE EVIDENCE BASE FOR BUNDLES IN PREVENTION OF SURGICAL SITE INFECTIONS
INTERPRETING THE EVIDENCE BASE FOR BUNDLES IN PREVENTION OF SURGICAL SITE INFECTIONS W LOWMAN MBBCh, MMed (Wits), FC Path (SA) Consultant Clinical Microbiologist and Infection Prevention and Control Specialist,
More informationQuality ID #424 (NQF 2681): Perioperative Temperature Management National Quality Strategy Domain: Patient Safety
Quality ID #424 (NQF 2681): Perioperative Temperature Management National Quality Strategy Domain: Patient Safety 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Outcome DESCRIPTION:
More informationCesarean Section Surgical Site Infection Prevention Evidence-Based Practices and Implementation Plan
Grand Valley State University ScholarWorks@GVSU Master's Projects Kirkhof College of Nursing 8-10-2017 Cesarean Section Surgical Site Infection Prevention Evidence-Based Practices and Implementation Plan
More informationStandardizing for Efficiency: Enhanced Recovery. Lillian S. Kao, MD, MS, CMQ July 23, 2018
Standardizing for Efficiency: Enhanced Recovery Lillian S. Kao, MD, MS, CMQ July 23, 2018 Disclosures Small intestine section editor for UpToDate. ERAS Preoperative Intraoperative Postoperative Enhanced
More informationCMS and NHSN: What s New for Infection Preventionists in 2013 Part II
CMS and NHSN: What s New for Infection Preventionists in 2013 Part II Joan Hebden RN, MS, CIC Clinical Program Manager Sentri7 Wolters Kluwer Health - Clinical Solutions Objectives Define the two major
More informationMedicare Value-Based Purchasing for Hospitals: A New Era in Payment
Medicare Value-Based Purchasing for Hospitals: A New Era in Payment Daniel J. Hettich March, 2012 I. Introduction: Evolution of Medicare as a Purchaser Cost reimbursement rewards furnishing more services
More informationPhysician Executive Council. Using the Perioperative Surgical Home to Improve Joint Replacement
Physician Executive Council Using the Perioperative Surgical Home to Improve Joint Replacement 9 Today s Presenters Julie Riley Physician Executive Council Senior Consultant 202-266-5628 RileyJu@advisory.com
More informationIdentifying Solutions / Implementation
Patient Safety Research Introductory Course Session 5 Identifying Solutions / Implementation Albert W Wu, MD, MPH Former Senior Adviser, WHO Professor of Health Policy & Management, Johns Hopkins Bloomberg
More informationTranslating recommendations into practice for surgical site infection prevention. Claire Kilpatrick IPC Global Unit SDS, HIS, WHO HQ
Translating recommendations into practice for surgical site infection prevention Claire Kilpatrick IPC Global Unit SDS, HIS, WHO HQ XXVIII e Congrès National de la Société Française d Hygiène Hospitalière
More informationInfection Prevention & Control Orientation for Housestaff Welcome to Shands at UF!
Infection Prevention & Control Orientation for Housestaff 2011 Welcome to Shands at UF! Hot Topics: Prevention Initiatives National Patient Safety Goal 07: Prevent Healthcare Associated Infections Prevent
More informationPossible Denominator Codes Applicable to OMS * Le Fort Fractures 21346, 21347, 21348, 21422, 21423, 21432, 21433, 21435, 21436
Individual PQRS s Eligible OMS #20: #22: Perioperative Care: Timing of Antibiotic Prophylaxis Ordering Physician. Percentage of surgical patients aged 18 years and older undergoing procedures with the
More informationHip Replacement Modern Total Hip Replacement in an Ambulatory Surgery Center. A Brief History of Total Hip Replacement
Modern Total Hip Replacement in an Ambulatory Surgery Center James T. Caillouette, M.D. Chairman Newport Orthopedic Institute 1 A Brief History of Total Hip Replacement Hip replacement 1990: LOS 7 Days
More informationAugust 1, 2012 (202) CMS makes changes to improve quality of care during hospital inpatient stays
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE Contact: CMS Media Relations
More informationImplementing an Enhanced Recovery Program for Surgery. Michael F. McGee, MD, FACS, FASCRS September 21, 2017
Implementing an Enhanced Recovery Program for Surgery Michael F. McGee, MD, FACS, FASCRS September 21, 2017 Continuing Education Disclosures Commercial Support or Sponsorship None Speaker or planner relationships
More informationACS NSQIP Pediatric Participant Use Data File (PUF)
ACS NSQIP Pediatric Participant Use Data File (PUF) Christine L. Sullivan, MBA, MS Continuous Quality Improvement, Division of Research and Optimal Patient Care American College of Surgeons July 22, 2017
More informationThe Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications
The Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications Christine M. Schleider, RN, BSN Adam P. Johnson, MD, MPH Kathleen M. Shindle, RN, BSN Scott W. Cowan, MD,
More informationSURGICAL SAFETY CHECKLIST
SURGICAL SAFETY CHECKLIST WHY: INFORMATION, RATIONALE, AND FAQ May 2009 Building a safer health system INFORMATION, RATIONALE, AND FAQ May 2009 - Version 1.0 The aim of this document is to provide information
More informationBest Practices to Optimize Postoperative Recovery
The OR Management Series Best Practices to Optimize Postoperative Recovery First Edition A compilation of articles from OR Manager OR Manager Elizabeth Wood, Editor Judith M. Mathias, MA, RN, Clinical
More information