title: The effect of Surgical Care Improvement Project (SCIP) compliance on surgical site infections (SSI).
abstract: BACKGROUND
  The Surgical Care Improvement Project (SCIP) has developed a set of process compliance measures in an attempt to reduce the incidence of surgical site infections (SSIs). Previous research has been inconclusive on whether compliance with these measures is associated with lower SSI rates.
  
  
  OBJECTIVE
  To determine whether hospitals with higher levels of compliance with SCIP measures have lower incidence of SSIs and to identify the measures that are most likely to drive this association.
  
  
  METHODS
  Analysis of linked SCIP compliance rates and SSIs on 295 hospital groups observed annually over the study period 2007-2010. A hospital group comprises all hospitals sharing identical categories for location by state, teaching status, bed size, and urban/rural location. We used a generalized linear model regression with logistic link and binomial family to estimate the association between 3 SCIP measures and SSI rates.
  
  
  RESULTS
  Hospital groups with higher compliance rates had significantly lower SSI rates for 2 SCIP measures: antibiotic timing and appropriate antibiotic selection. For a hospital group of median characteristics, a 10% improvement in the measure provision of antibiotic 1 hour before intervention led to a 5.3% decrease in the SSI rates (P<0.05). Rural hospitals had effect sizes several times larger than urban hospitals (P<0.05). A third-core measure, Timely Antibiotic Stop, showed no robust association.
  
  
  CONCLUSIONS
  This analysis supports a clinically and statistically meaningful relationship between adherence to 2 SCIP measures and SSI rates, supporting the validity of the 2 publicly available healthcare-associated infection metrics.
authors.affiliation: *IMPAQ International, LLC, Columbia, MD †US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, DC ‡RAND Corporation, Santa Monica, CA.
authors.forename: Guido
authors.initials: G
authors.lastname: Cataife
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Weinberg
authors.forename: Hui-Hsing
authors.initials: HH
authors.lastname: Wong
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Kahn
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003428:Cross Infection / Q000517:prevention & control; D019983:Guideline Adherence; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000592:standards / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000458:organization & administration; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents