Perform an SSI Investigation

1. Perform an SSI Investigation Deb Hobson, RN BSN March 10 & 12, 2014

2. Objectives • Distinguish between process and outcome data. • Describe how the SSI Investigation Tool can guide improvement work even when SSI rates are low. • Adapt an SSI Investigation Tool to reflect the care processes in your SSI Prevention Bundle. Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

3. SUSP Readiness Bridge • Are your frontline SUSP team members aware of the SUSP project? • Have you completed a safety culture survey (e.g. HSOPS) and debriefed your frontline SUSP team members? • Has your staff received the Science of Safety Training? • Have you collated Perioperative Staff Safety Assessment responses from your staff? • Have you held your Executive Safety Rounds Kickoff meeting? Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

4. Collect process and outcome data to assess current performance and progress towards improving patient care. Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu. Assess Your Performance

5. Get SSI Data from the SUSP Website Log onto the SUSP Website Locate the SSI Data Registry Access your SSI Data Report Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

6. Log onto the SUSP Website Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

7. Locate the SSI Data Registry Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

8. Access your SSI Data Report

9. Sample SSI Data Report

10. Always room for improvement Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

11. 1 Organ Space SSI means… • 4.9% mortality rate • $14,448 additional cost of care • 24 additional length of stay

12. Because a multitude of factors influence outcome, it is not possible to know for certain, even after extensive adjustments for differences in case mix are made, the extent to which an observed outcome is attributable to an antecedent process of care. Confirmation is needed by a direct assessment of the process itself…” AvedisDonabedian (1998) Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

13. Uncover Defects with SSI Investigation Tool Identify lapses in infection prevention processes that may have contributed to your SSI case. Assess adherence to your local SSI Prevention Bundle. Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

14. Patient or Provider Factors

15. Normothermia Maintenance

16. Glucose Control Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

17. Antibiotic Redosing

18. Adapt the SSI Investigation Tool • Johns Hopkins Hospital clinicians designed this tool to assess adherence to their local SSI Prevention Bundle. • Your team may want to investigate care processes that are not included in this tool. • This tool may include processes that your team does not use. • Please modify this tool to best fit your team’s needs. Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

19. What Your Team Can Do Abstract this information from the patient’s chart. Use SSI Audit tools to dig deeper into your care delivery system. Present process data to the team at a routine SUSP meeting. Share investigation results monthly or quarterly with your frontline staff and OR leadership. Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

20. Next Steps Complete an SSI investigation of your most recent SSIs. Share your findings on a March coaching call. Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

21. What questions do you have? • Remember you have a support network • You can ask questions any time on MedConcert • You can ask questions during coaching calls • You can contact the SUSP helpdesk Questions? Contact the SUSP helpdesk at SUSP@jhmi.edu.

22. Content Call Evaluation We want to ensure that the content calls provide useful and pertinent information for the SUSP teams. For this reason we request that you complete a brief evaluation following each call. The evaluation may be found at the following link: https://www.surveymonkey.com/s/SUSP_Cohort4