title: Multicentred surgical site infection surveillance using partitioning analysis.
abstract: BACKGROUND
  Surgical site infection (SSI) is an ongoing major public health problem throughout the world that increases healthcare costs. Utilizing a methodology that can help clinicians to continuously collect data about SSIs, analyse it and implement the feedback into routine hospital practice has been identified as a top national priority in Japan.
  
  
  OBJECTIVE
  To conduct an intervention study through 'operations research' using partitioning at multiple facilities, and to reduce the incidence and consequences of SSI.
  
  
  METHODS
  The Setouchi SSI Surveillance Group, which consists of seven institutes, started SSI surveillance in 2006. Until May of 2008, there were four surveillance periods (A-D). In all, 3089 patients underwent gastrointestinal surgery and were followed up for 30 days after their operations. Twenty-six factors that have been reported to be related to SSI were evaluated for all patients. The top three factors from each surveillance period were determined and then actual practice improvements were planned for each subsequent period.
  
  
  RESULTS
  The total SSI occurrence was 6.9% for period A, 6.3% for period B, 6.4% for period C and 3.9% for period D. Comparing periods A and D, there was a statistical significance in the decrease of SSI occurrence (P = 0.012).
  
  
  CONCLUSIONS
  Using the results and partitioning analysis of active SSI surveillance to contribute to action plans for improving clinical practice was effective in significantly reducing SSIs.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Naomoto
authors.forename: T
authors.initials: T
authors.lastname: Yamatsuji
authors.forename: Y
authors.initials: Y
authors.lastname: Shirakawa
authors.forename: S
authors.initials: S
authors.lastname: Tanabe
authors.forename: K
authors.initials: K
authors.lastname: Noma
authors.forename: T
authors.initials: T
authors.lastname: Kimura
authors.forename: H
authors.initials: H
authors.lastname: Aoki
authors.forename: H
authors.initials: H
authors.lastname: Matsukawa
authors.forename: M
authors.initials: M
authors.lastname: Kimura
authors.forename: Y
authors.initials: Y
authors.lastname: Nonaka
authors.forename: H
authors.initials: H
authors.lastname: Sasaki
authors.forename: T
authors.initials: T
authors.lastname: Onoda
authors.forename: Y
authors.initials: Y
authors.lastname: Otawa
authors.forename: M
authors.initials: M
authors.lastname: Takaoka
authors.forename: T
authors.initials: T
authors.lastname: Fukazawa
authors.forename: Y
authors.initials: Y
authors.lastname: Ohno
authors.forename: T
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*
keywords: Active surveillance; Partitioning analysis; Surgical site infection