Reducing surgical complications.
BACKGROUND
One of the 12 interventions that the Institute for Healthcare Improvement (IHI) recommends for its 5 Million Lives Campaign is "Reduce Surgical Complications...by reliably implementing all the changes in care recommended by the Surgical Care Improvement Project (SCIP)." Many surgical patients experience complications from surgery, some of which are preventable with the reliable application of evidence-based medicine. Despite promotion and dissemination of recommendations and practices, overall national compliance remains less than optimal.


METHODS
IHI's 5 Million Lives Campaign is supporting the recommended practices in the SCIP to accelerate adoption for reduction in surgical complications by 25% by December 2008. Practices relate to surgical site infection prevention, prophylaxis for venousthromboembolism, continuation of beta blockers, and prevention of postoperative pneumonia. Strategies used in hospitals that have achieved improvement in the recommended SCIP measures include practices that increase reliability and minimize practice variation. These changes, along with efforts to improve teamwork and communication, are essential to reduce surgical complications.


CONCLUSIONS
Organizations that strive for high reliability in their processes should see improvement in the associated outcomes and a reduction in harm to patients.
Griffin
Frances A
FA
Institute for Healthcare Improvement, Cambridge, MA, USA. fgriffin@ihi.org
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D003428:Cross Infection / Q000517:prevention & control; D004334:Drug Administration Schedule; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D010348:Patient Care Team / Q000458:organization & administration; D018410:Pneumonia, Bacterial / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control*; D011787:Quality of Health Care / Q000458:organization & administration*; D013530:Surgical Wound Infection / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000517:prevention & control
D000319:Adrenergic beta-Antagonists