- OSHA Healthcare Advisor - http://blogs.hcpro.com/osha -

It’s “all-or-none” when it comes to post-op infection prevention measures

For the last four years participating hospital have used six post-operative infection prevention measures from the Surgical Care Improvement Project [1] (SCIP), including public reporting on compliance with those measures.

But a study published in the June 23/30 issue of the Journal of the American Medical Association (JAMA) [2], concludes that adherence to individual measures are “not associated with a significantly lower probability of infection.”

Instead the authors determined that adherence to a “global all-or-none” approach lead to a much lower probability of post-operative infections. Adherence to this method resulted in a decreased likelihood of developing a postoperative infection from 14.2 to 6.8 postoperative infections per 1,000 discharges.

The SCIP measures are:

“Based on our findings, the individual item performance rates reported publicly do not fulfill their stated purpose of pointing consumers toward high-quality hospitals,” the authors wrote. “However, when taken in aggregate, improved performance on our global all-or-none composite measure is associated with improved outcomes at the discharge level. Therefore, while the individual items may not imply quality differences, the overall ability to demonstrate adherence to multiple SCIP processes of care may. Improved methods for identification of quality of care are necessary to be able to define improvements in patient outcomes, and to justify the massive investment of time and money in tracking these processes of care.”