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Colorectal SSIs Plummet After Targeted Improvement Project

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Tailor Your Approach to Quality Improvement

This is an innovative and exciting initiative that highlights our increasing sophistication about translating new knowledge and evidence into practice. In order to improve something, you must first document that there is a problem, establish a baseline, and set a goal.

The American College of Surgeons National Surgical Quality Improvement Program and similar initiatives allow for such a structured and standardized approach for data collection and reporting. Once the problem is characterized, interventions must be designed and tested in a variety of settings to determine under what conditions they are or are not effective.

No single intervention will be effective for a multifactorial problem like surgical site infections. In order to scale up and broadly disseminate such interventions, it is necessary to assess the facilitators and barriers to change that exist in a given environment to determine which interventions have the highest likelihood of success. The program described in this article, which allows such a tailored approach to quality improvement, potentially can have a profound impact on the quality and safety of the care that we provide.

Dr. Caprice C. Greenberg is an ACS Fellow, associate professor of surgery, and director of the Wisconsin Surgical Outcomes Research at the University of Wisconsin, Madison.


 

"This is a problem colorectal surgeons have been struggling with for years," Dr. Chassin said. "We’ve always tried to get at it with the simple answer: ‘Here are 5 or 10 things everyone should do to decrease SSIs.’ That doesn’t work, because the critical factors that explain poor outcomes differ from one place to another. The best advice I can give is to look at all your contributing factors and assess where your organization falls short. Use these findings as a guide for where to focus your improvement efforts. The only way you know how to improve is to measure the cause of problems and target interventions right to them."

No disclosures were reported.

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