Interdisciplinary Surgical Care Improvement Project (SCIP)
By Millie Russin
SHANDS AT UF CLINICAL PROCESS IMPROVEMENT DIRECTOR
Thomas Beaver, M.D., associate professor of thoracic and cardiovascular surgery, and Gail Avigne, R.N., B.A., C.N.O.R., outpatient services nurse manager at Florida Surgical Center, are co-chairs for Shands at UF’s interdisciplinary Surgical Care Improvement Project Team. The team is charged with helping us achieve top performance on a number of evidence-based care process measures designed to reduce the rate of surgical infections. Our performance is reported in comparison to other hospitals throughout the United States on the CMS Hospital Compare website (www.hospitalcompare.hhs.gov).
These measures reflect the care we provide to patients undergoing cardiac surgery, including coronary artery bypass graft surgery; colon surgery; hip and knee replacements; hysterectomy; and vascular surgery. A limited subset of these measures applies to additional types of major surgery. While most of the metrics pertain to adult patients, temperature management applies to patients of all ages, including neonates.
Our performance is measured on the timing, selection and discontinuation of prophylactic antibiotics; blood sugar control for cardiac surgery patients; appropriate surgical hair removal by avoiding razors; control of body temperature by warming patients during surgery; prevention of veno-thromboembolism (blood clots in the leg veins); and discontinuing urinary catheters by the end of the second postoperative day.
Our composite score has substantially improved since 2008 and our rate of surgical site infections is declining!
Contributing to these improvements include:
- providing rapid feedback when a patient does not receive the recommended antibiotic in the correct time frame
- sending a weekly report to anesthesiologists, surgeons and Operating Room nurses, celebrating the number of days that all patients have received preoperative antibiotics in the recommended time frame
- revising the postoperative order sets by limiting the number of prophylactic antibiotic doses to ensure that patients do not receive unnecessary doses