Navigation Links
Reported surgical quality measures not associated with lower infection rates

A study by investigators at Case Western Reserve University School of Medicine published in this week's issue of JAMA found that public hospital comparison data reported by the U.S. Department of Health and Human Services does not accurately correlate with a patient's risk for surgical postoperative infection. The retrospective, cohort study of more than 400,000 patients from 398 hospitals nationwide examined the relationship between reported adherence to six infection prevention Surgical Care Improvement Project (SCIP) measures and the probability of patient postoperative infection.

"The SCIP has done an outstanding job of designing and identifying proper infection prevention measures, but there is still more work to be done," says Jonah J. Stulberg, MD, PhD, MPH, a recent graduate of Case Western Reserve University School of Medicine, and the lead author of the study. "Our analysis shows that using a multi-measure approach to prevention is associated with a lower probability of patient infection, and that is something I think everyone can appreciate."

Due to new Value-Based Purchasing (VBP) incentives under the recently passed Health Care Reform Act, Medicare reimbursement will be tied to hospitals' adherence to SCIP measures. Researchers found that using a composite infection prevention score, one that assesses more than two measures per patient visit, was more accurate in predicting the probability of a patient developing a postoperative infection. It predicted approximately a 15 percent decreased risk of postoperative infection.

Within the current system, Medicare reports performance only on individual SCIP measures. Dr. Stulberg, who will soon begin his residency in the Department of Surgery at University Hospitals Case Medical Center, and his co-authors recommend SCIP require multiple measures be performed and recorded at every single patient visit. They found this will result in a more accurate prediction of whether a patient will develop a postoperative infection.

"Our inability to demonstrate a statistically significant association between individual measures and clinical outcomes at the patient level suggests that the rates, as reported on the Hospital Compare website, do not necessarily infer quality differences between hospitals," explains Siran Koroukian, PhD, Associate Professor of Epidemiology and Biostatistics at Case Western Reserve University School of Medicine and senior author of the study. "However, the multi-measure model in our study better captures the culture of quality in hospitals."

The SCIP is a national quality partnership dedicated to reducing the rate of surgical complications. It is the first, and largest, movement to measure the quality of care delivered for surgical patients in the U.S. Comprised of 20 measures covering various discrete elements of patient care, the six measures examined in this study focus on infection prevention efforts, which include:

  • Patients who received antibiotics within one hour prior to surgery
  • Patients who received the appropriate antibiotic for their specific procedure
  • Patients whose antibiotics were discontinued within 24 hours after surgery
  • Cardiac surgery patients with a controlled postoperative blood glucose level
  • Surgery patients with appropriate surgical site hair removal
  • Colorectal surgery patients with immediate postoperative normothermia

Although SCIP prevention measures give a strong indication of postoperative infection complication rates, there are several factors independent of the measures which may play an important role in determining the rates. Other aspects influencing surgical patient outcomes include the skill and knowledge of the surgical team, a safe and clean working environment, and a general culture of quality surrounding patient care are likely to be at least as important to the assessment of hospital quality.


Contact: Christina DeAngelis
Case Western Reserve University

Related medicine news :

1. Patient-reported outcomes study shows improvements in quality of life among patients after 1 year of treatment with TYSABRI
2. Rapid development of drug-resistant 2009 H1N1 influenza reported in 2 cases
3. Violence is part of the job say nurses as study shows only 1 in 6 incidents are reported
4. Mortality rates for pediatric rheumatology patients significantly lower than previously reported
5. The Washington Post Reported That Cyber Monday Website Traffic Rises 8%. Bostons Bella Sante Day Spas Cyber Monday Website Traffic Rises 76%.
6. Optimal surgical procedure for duodenal gastrointestinal stromal tumors
7. Spectrum Surgical Instruments Appoints President, Chief Operating Officer
8. GYN Oncologist Uses da Vinci Surgical Robot to Preserve Fertility
9. Spectrum Surgical Instruments Corp. Announces: Cleanables™ Instrument Cleaning Brushes
10. Jackson Surgical Assistants Expands Its National Presence by Merging with Two Atlanta Area Practices
11. Surgical procedure offers new option for pediatric patients with rare cancer in abdomen
Post Your Comments:
(Date:6/27/2016)... ... , ... recently awarded their highest five-star rating to Best Buy Eyeglasses, ... the United States and Canada wear eyeglasses. Once considered to be a purely functional ... a fashion statement. Even celebrities use glasses as a way of creating an iconic ...
(Date:6/26/2016)... ... 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media Slicing ... their videos a whole new perspective by using the title layers in ProSlice ... , ProSlice Levels contains over 30 Different presets to choose from. FCPX ...
(Date:6/26/2016)... Lake Orion, Clarkston, Michigan (PRWEB) , ... June ... ... direction with respect to fertility once they have been diagnosed with endometriosis. These ... tolerable intercourse but they also require a comprehensive approach that can help for ...
(Date:6/25/2016)... ... ... of Bruton Memorial Library on June 21 due to a possible lice infestation, as reported ... head lice: the parasite’s ability to live away from a human host, and to infest ... in the event that lice have simply gotten out of control. , As lice are ...
(Date:6/25/2016)... ... 2016 , ... As a lifelong Southern Californian, Dr. Omkar Marathe earned his ... David Geffen School of Medicine at UCLA. He trained in Internal Medicine at Scripps ... in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the opportunity to ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016   Bay ... Rehabilitation Network,s Dean Center for Tick Borne ... Medicine and Rehabilitation, MIT Hacking Medicine, University of ... Innovation, today announced the five finalists of ... Lyme disease.  More than 100 scientists, clinicians, researchers, ...
(Date:6/24/2016)... , June 24, 2016 ... of the "Structural Electronics 2015-2025: Applications, Technologies, ... In-Mold Electronics, Smart Skin, ... Photovoltaics Structural electronics involves electronic ... load-bearing, protective structures, replacing dumb structures such as ...
(Date:6/24/2016)... 2016 Dehaier Medical Systems Ltd. (NASDAQ: ... markets and sells medical devices and wearable sleep respiratory ... strategic cooperation agreement with Hongyuan Supply Chain Management Co., ... June 20, 2016, to develop Dehaier,s new Internet medical ... Dehaier will leverage Hongyuan Supply Chain,s sales platform to ...
Breaking Medicine Technology: