Safety Program Reduces Surgical Site Infections in Hawaii Hospitals

Surgical site infections fell more than 61 percent and patient safety culture improved following implementation of AHRQ’s Comprehensive Unit-based Safety Program (CUSP), a newly published study has found. The study, published in the Journal of the American College of Surgeons, analyzed data from hospitals in Hawaii performing colorectal surgeries from 2013 to mid-2015. It found that participation in AHRQ’s Safety Program for Surgery, which featured CUSP, was associated with a 61.7 percent decrease in surgical site infections, from 12 percent to 4.6 percent. Meanwhile, patient safety culture, as measured by AHRQ’s Hospital Survey on Patient Safety Culture, improved in 10 of 12 categories. CUSP is a safety program that combines clinical best practices with an understanding of the science of safety, improved safety culture and an increased focus on teamwork. Access the study abstract. Also, access a toolkitdeveloped in the AHRQ national project. Additionally, information is available about a current AHRQ national project focused on care of surgical patients, the AHRQ Safety Program for Improving Surgical Care and Recovery.

AHRQ Safety Program for Improving Surgical Care and Recovery

A collaborative program to enhance the recovery of surgical patients

This ongoing implementation project aims to help hospitals and clinicians use AHRQ’s Comprehensive Unit-based Safety Program (CUSP) method to enhance the surgical process and improve patients' recovery after surgery.

About This Project

This project is designed to help hospitals implement evidence-based practices to improve outcomes and prevent complications among patients who undergo surgery. Enhanced recovery pathways include preoperative, intraoperative, and postoperative practices that decrease complications and accelerate recovery. A number of studies and meta-analyses have demonstrated successful results from the use of these pathways. In order to facilitate broader adoption of these evidence-based practices among U.S. hospitals, this AHRQ project will use principles and methods from CUSP, which has been demonstrated to be an effective approach to reducing patient harms including healthcare associated infections, to enhance the recovery of surgical patients. The CUSP approach uses a combination of clinical and cultural (i.e., technical and adaptive) intervention components. The adaptive elements include promoting leadership and frontline staff engagement, improvement in safety culture, and close teamwork among surgeons, anesthesia providers, and nurses, as well as enhancing patient communication and engagement. Through this project, AHRQ will help approximately 750 hospitals implement surgical practices designed to reduce infections and other complications. These practices can also reduce the length of time patients stay in the hospital after surgery and help them recover safely at home without unplanned returns to the hospital.

Tools and resources used and lessons learned by the hospitals participating in this 5-year project will be compiled into a toolkit, allowing other hospitals to improve patient recovery.

Project Partners

This project is being conducted through a partnership that brings together subject matter experts and providers in the field. Partners for this project include—

Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality
American College of Surgeons
Westat

For health care professionals who wish to learn more about how to enroll your hospital in this project, visit the Improving Surgical Care and Recovery (ISCR) portal

Page last reviewed June 2017
Page originally created March 2017

Internet Citation: AHRQ Safety Program for Improving Surgical Care and Recovery. Content last reviewed June 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/enhanced-recovery/index.html