Surgical Site Infection (SSI) Prevention
The Surgical Site Infections (SSI) Prevention Advanced Application is aimed at hospital infection prevention teams, clinical and operational directors, hospital leadership and members of quality improvement teams. The SSI application enables users to efficiently find, review, and document SSI cases to support NHSN (National Healthcare Safety Network) reporting and to review outcomes and trends of SSI across institutions and health systems. It also provides near real-time analysis of internal processes related to SSI to support care process improvement.
- Performance dashboard to visualize SSI rates and case counts for NHSN by OR location, surgeon, ASA score, etc.
- Surveillance worklist and workflow tools speed SSI surveillance.
- Patient detail tab: Gives a one-page summary of the patient demographics, surgery scheduling, and surgical case data, along with key data for case participants, diagnosis, preoperative labs, preoperative antimicrobials, surgical risk factors, and bundle compliance measures.
- Intervention measurements: Track surgical bundle compliance and other interventions.
- Trending views: Track performance on outcome and process metrics.
- Comparison analytics: Compare performance across different patient groups by surgeon, OR room, procedure, etc.
- Export or print capability: For patient lists, metric performance, etc.
- Rapidly find, assess and document SSI according to NHSN definitions
- Efficiently review NHSN submission data and SSI rates
- Easily identify trends in performance and SSI prevention bundles compliance
- Discover differences in outcomes based on various stratifications (OR location, Surgical service, department, provider, date, comorbidity, e.g.)
- Drill down to the facility, unit, service, or patient level to analyze performance, provide feedback, and support measurement of performance improvement interventions
Available Measures Include:
- SSI Rate
- SSI Count
- Case Count
- Encounter Count
- Patient Count
- Intervention Counts and Composite Score
- Hospital billing records
- Professional billing system(s)
- Surgery scheduling and surgery case data
According to the CDC (2015), SSI is the leading hospital-acquired infection. Despite advances in infection control practices, SSIs remain a substantial cause of mortality, morbidity, prolonged hospitalization, and excess cost. To reduce SSI risk, the CDC promotes surveillance of SSI with feedback of appropriate data to surgeons. In addition to SSI rate data, feedback should also be provided on compliance with pre-surgical processes known to decrease SSI risk. The SSI app streamlines this surveillance and feedback, while also providing the opportunity to dive more deeply into the data to discover possible reasons and opportunities to inform outcome improvement efforts.
What types of problems does SSI Prevention address?
Hospitals are required to track and report SSI rates to CMS via the CDC NHSN reporting system. Due to CMS payment penalties and high excess costs, health system are eager to improve outcomes for their patients. However, organizations are frequently so focused on the task of finding, validating, and reporting SSI data externally—that they struggle to resource efforts to analyze date, identify root cause, and provide effective intervention to actively decrease SSI rates and improve outcomes.
- A hospital executive reviews the SSI report from the Infection Prevention Committee and wants to know what is being done to decrease SSI rates to avoid payment penalties.
- An infection prevention team member discovers an increasing trend of higher-than-system-average SSI rate in a particular group of patients. They want to engage with a surgical care improvement team to improve processes to decrease SSI rates; however, they are so busy conducting surveillance for SSI rates, they don’t have time to focus on improvement.
- The surgical care process improvement team wants to measure the impact of a new colorectal surgery bundle on SSI rates. The team uses the app to look at compliance with the new process and the trend in SSI rates since implementation of the new process.
- An infection prevention team member is assigned to conduct surveillance and documentation of SSI cases in preparation for submitting to NHSN for a specific hospital. She uses the SSI Prevention advanced app to quickly identify SSI cases and finds it dramatically more efficient than her usual manual surveillance methods. In addition, she’s able to identify an apparent trend of increased infection rates in bowel surgeries. The application helps her investigate preoperative care processes and develop a hypothesis, based on actual compliance date. Within a short time, she has data to share with the medical director for GI surgery demonstrating the trend in SSI and supporting data on SSI prevention bundles.
- Increased compliance with practices shown to decrease SSI: pre-op antimicrobials, glucose management, CHG skin prep, thermoregulation, etc.
- Lower SSI rate.
- Revelation of system-wide variation in SSI rates and variation in internal processes related to SSI (e.g., compliance with infection control bundles).
- More efficient and reliable NHSN reporting.
- Infection Prevention resources redirected to analysis, feedback, and intervention to improve SSI prevention process and outcomes.
- Increased insight into trends, populations, practice and performance—increased ability to uncover the “why” behind SSIs and the “where” to focus improvement efforts.
Success Measure Examples
There are 3 types of success measures:
- Measure and broadly share SSI rates and SSI PREVENTION BUNDLES compliance measures across the enterprise to help make visible the opportunities for improvement.
- XX% improvement in compliance with selection and timing of preoperative antimicrobials (part of SSI prevention bundles).
- Decrease SSI rate or SSI specific readmission rate by XX%.