title: Description of a multidisciplinary initiative to improve SCIP measures related to pre-operative antibiotic prophylaxis compliance: a single-center success story.
abstract: BACKGROUND
  The Surgical Care Improvement Project (SCIP) was launched in 2005. The core prophylactic perioperative antibiotic guidelines were created due to recognition of the impact of proper perioperative prophylaxis on an estimated annual one million inpatient days and $1.6 billion in excess health care costs secondary to preventable surgical site infections (SSIs). An internal study was conducted to create low cost, standardized processes on an institutional level to improve compliance with prophylactic antibiotic administration.
  
  
  METHODS
  We assessed the impact of auditing and notifying providers of SCIP errors on overall compliance with inpatient antibiotic guidelines and on net financial gain or loss to a large tertiary center between March 1st 2010 and September 31st 2013. We hypothesized that direct physician-to-physician feedback would result in significant compliance improvements.
  
  
  RESULTS
  Through physician notification, our hospital was able to significantly improve 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 re-investment in patient care initiatives.
  
  
  CONCLUSIONS
  Provider education and direct notification of SCIP prophylactic antibiotic dosing errors resulted in improved compliance with national patient improvement guidelines. There were differences between the anesthesiology and surgery department feedback responses, the latter likely attributed to diverse surgical department sub-divisions, frequent changes in resident trainees and supervising attending staff, and the comparative ability. Provider notification of guideline non-compliance should be encouraged as standard practice to improve patient safety. Also, the hospital experienced increased revenue for re-investment in patient care as a secondary result of provider notification.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Hospital, Boston, MA USA.
authors.forename: Tori
authors.initials: T
authors.lastname: Sutherland
authors.affiliation: Center for Clinical Excellence, Brigham and Women's Hospital, Boston, MA USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beloff
authors.affiliation: Center for Clinical Excellence, Brigham and Women's Hospital, Boston, MA USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Lightowler
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02115 USA.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02115 USA.
authors.forename: Luigino
authors.initials: L
authors.lastname: Nascimben
authors.affiliation: Chairman, Department of Anesthesiology, LSUHSC, School of Medicine, New Orleans, LA USA.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Kaye
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02115 USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
keywords: Patient safety; Provider notification; Surgical care improvement project (SCIP); Surgical site infection (SSI)