title: Process measures to improve perioperative prophylactic antibiotic compliance: quality and financial implications.
abstract: The Surgical Care Improvement Project (SCIP) was launched in 2005. The core prophylactic perioperative antibiotic guidelines were created because of recognition of the impact of proper perioperative prophylaxis on an estimated annual 1 million inpatient days and $1.6 billion in excess health care costs that are secondary to preventable surgical site infections. There is a need to create low-cost, standardized processes on an institutional level to improve compliance with prophylactic antibiotic administration. The impact of interventions on provider compliance with SCIP inpatient antibiotic guidelines and net financial gain or loss to a large tertiary center were assessed. A single hospital was able to significantly improve their SCIP compliance and emphasis on patient safety within a year of intervention implementation. The hospital earned an additional $290,612 in 2011 and $209,096 in 2012 for reinvestment in patient safety initiatives. Low-cost interventions aimed at educating providers that utilize existing infrastructure result in improved SCIP compliance and patient safety. As a secondary gain, there were hundreds of thousands of dollars in annual cost savings. The impact of compliance on infection rates is inferred but requires further study.
authors.affiliation: Author Affiliations: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center (Dr Sutherland); Center for Clinical Excellence (Ms Beloff and Ms Lightowler); and Department of Anesthesiology, Perioperative and Pain Medicine (Ms Liu, Drs Nascimben and Urman), Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Tori
authors.initials: T
authors.lastname: Sutherland
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beloff
authors.forename: Marie
authors.initials: M
authors.lastname: Lightowler
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Liu
authors.forename: Luigino
authors.initials: L
authors.lastname: Nascimben
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003365:Costs and Cost Analysis / Q000191:economics*; D006761:Hospitals; D006801:Humans; D061214:Patient Safety; D059035:Perioperative Period; D017064:Process Assessment, Health Care / Q000379:methods*; D058996:Quality Improvement; D013514:Surgical Procedures, Operative / Q000592:standards*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents