Identifying opportunities for quality improvement in surgical site infection prevention
published online 09 February 2009.
Background
This study evaluated surgical site infection (SSI) prevention strategies at a network of university hospitals to identify interventions that may be required to improve compliance with guidelines.
Methods
Qualitative methods were used for thematic analysis of institutional tools and protocols, and transcripts of interviews with 7 surgical division heads and 11 professional managers of quality improvement or infection prevention and control at 7 hospitals. They were asked about awareness of, and accountability for, SSI prevention, and current and recommended strategies to promote compliance.
Results
Despite awareness of SSI prevention guidelines and the presence of organizational factors thought necessary for quality improvement (coordinators, champions), most sites had not reviewed their own practice and implemented corrective strategies. Barriers included use of passive educational strategies, lack of clinician accountability, limited implementation of point-of-care tools, and an absence of performance data.
Conclusion
The sites involved in this evaluation and others interested in increasing compliance with SSI prevention guidelines might implement education and performance data in tandem with accountabilities that trigger action, more actively engage champions to promote SSI prevention, create or update and incentivize use of tools such as standard orders, and encourage greater teamwork through organizational support of quality improvement.
aSunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Address correspondence to Anna Gagliardi, PhD, Scientist, Sunnybrook Health Sciences Centre, assistant professor, Department of Surgery, Department of Health Policy, Management & Evaluation, Faculty of Medicine, University of Toronto, 2075 Bayview Ave, Toronto, Ontario, Canada M4N3M5.
Supported by a research grant from Colon Cancer Canada.
ABSTRACT