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Lessons learned from the institution of the Surgical Care Improvement Project at a teaching medical center
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Lessons learned from the institution of the Surgical Care Improvement Project at a teaching medical center
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Journal Article
Lessons learned from the institution of the Surgical Care Improvement Project at a teaching medical center
2009
Overview
The Surgical Care Improvement Project (SCIP) was designed to reduce perioperative complications. We describe our institutional experience in 6 major areas: surgical site infection, venous thromboembolism prevention, use of perioperative β-blockade, serum glucose level greater than 200 mg/dL, normothermia, and the use of electric razors for hair removal.
This was a retrospective review of surgical cases. Evidence-based training and standardization of system and process were undertaken. Compliance with SCIP guidelines was determined.
Overall SCIP compliance improved from 80% to 94% over a 2-year period. Standardized antibiotic dosing times improved compliance to more than 90%. Appropriate preoperative antibiotic choice improved to 100%. Cessation of antibiotics postoperatively within 24 hours remains a difficult task. Venous thromboembolism prophylaxis has been difficult to achieve because of postoperative bleeding concerns. Administration of β-blockers has remained one of the most difficult problems to correct because of the multiplicity of avenues by which a patient may arrive to the operating suite.
Achievement of the SCIP goals is a formidable, but achievable, process requiring individual, cultural, systems, and institutional changes to achieve success.
Publisher
Elsevier Inc,Elsevier,Elsevier Limited
Subject
/ Adrenergic beta-Antagonists - therapeutic use
/ Biological and medical sciences
/ Bleeding
/ Glucose
/ Hair
/ Human infectious diseases. Experimental studies and models
/ Humans
/ Medicaid
/ Outcome and Process Assessment (Health Care)
/ Performance improvement quality measures
/ Postoperative Complications - prevention & control
/ Quality
/ Razors
/ Surgeons
/ Surgery
/ Surgical care infection project
/ Surgical Procedures, Operative - standards
/ Surgical Wound Infection - prevention & control
/ Trends
