Surgical Site Infections (SSIs) signify a significant healthcare challenge, affecting up to 4% of inpatient surgical procedures, often leading to debilitating consequences such as extended hospital stay, increased mortality, and repeat hospital admittances according to research by Agency for Healthcare Research and Quality. In this regard, Banner Health presents an intriguing case study on combating SSIs, which might serve as a reference for hospitals looking to improve their surgical outcomes and patient health.
Banner Health, a major US healthcare provider, recently reported its implementation of a comprehensive Surgical Antimicrobial Prophylaxis (SAP) bundle designed to reduce SSIs. Having presented at the APIC Annual Conference, they revealed impressive data covering 57,000 surgical cases spanning January 2019 through December 2023. The data consisted of four types of surgery—hip arthroplasty, knee arthroplasty, colorectal surgery, and abdominal hysterectomy.
The core of the SAP bundle rests upon meticulous antibiotic management, as elucidated by William Holland, MD, MHA, Senior VP of Care Management and Chief Medical Informatics Officer at Banner Health. The SAP bundle emphasizes three aspects: ensuring patients receive the correct antibiotic before surgery, administering the appropriate dose based on the patient’s weight, and correctly timing antibiotic administration. For longer surgeries, the bundle includes a provision for re-dosing.
The results from implementing this bundle were striking—SSI rates for knee arthroplasty saw a 15.2% decline, hospital stays decreased by four days on average, mortality rates dropped by 4.4%, and average 30-day hospital readmission rates fell by 3.9%.
The SAP bundle was developed and deployed in line with Banner Health’s model for performance improvement. This model starts with clinical leaders identifying potential opportunities in medical literature or their internal data. In this case, clinical consensus groups consisting of peers across their healthcare system scrutinized both literature and internal data in order to drive consistency across the organization.
Endorsed by the clinical consensus group, the SAP bundle then went up the administrative chain to the clinical leadership team who greenlit it as a standard expected practice. Necessary resources were then organized which included process engineers, informatics, and program managers to facilitate the implementation of the bundle across Banner Health’s hospitals. The most challenging aspect of the implementation process was the re-dosing of antibiotics during surgery, calling for additional measures to educate surgical teams and providing reminders.
Key to the success of the bundle was the involvement of physicians and nurses in the design and implementation process. Banner Health also strived for consistency in the application of the bundle across all medical facilities to ensure the same level of care afforded to every patient irrespective of the hospital they were treated at.
In summary, SAP bundles like those implemented by Banner Health can serve as effective tools in combating SSIs. Underpinned by meticulous planning, wide-scale staff involvement, and consistent application, these measures can significantly improve surgical health outcomes across the spectrum.
Source: https://www.healthleadersmedia.com/cmo/banner-health-initiative-reduces-surgical-site-infections