Emotions and Research behind Solutions to SSI Reduction
By Sue MacInnes | April 7, 2017
Thank you Boston! All of us at Medline were captivated by your charm, your history and passion.
Thank you AORN for giving Medline an opportunity to launch our ERASE SSI program. Leading up to when the exhibit hall opened, we were excited to share both the research and background to our Surgical Site Infections (SSIs) solutions, but more importantly the solutions.
We opened the show with a countdown. I mean literally a countdown for 30 minutes until the “reveal.”
I was surprised by the swarm of people. As the group grew at our booth, I talked to many people about infections, patient feelings—such as being “let down by their healthcare provider,” as well as the empathy and frustration of staff.
If I was to summarize the mood of providers and vendors, I would say there has been a shift from “product focus” to “solution focus.” That may sound cliché, but I am talking about REAL solutions, not a theory. Today’s healthcare professionals want help, collaboration and aligned incentives. It’s about strategic partnering to improve outcomes clinically, operationally and experientially.
Why We Started Looking at SSI Reduction
In 2008, the Joint Commission created the Center for Transforming Healthcare. The Center includes about 27 hospitals which were set up to focus on improving care and using six sigma strategies to uncover barriers that contribute to mistakes and poor metrics of healthcare quality outcomes.¹
The hospitals identify priority projects, one of which was Colorectal Surgical Site Infections. We knew this was an area of measurement for the Centers for Medicare & Medicaid Services (CMS) and one of the most difficult surgeries in SSI prevention. For this particular research, there were seven hospitals included. Great hospitals like the Cleveland Clinic, Stanford and the Mayo Clinic to name a few, and they identified variables that contributed to SSIs. There were about 42 variables occurring anywhere from pre-surgery planning at home to post-surgery to when they’re discharged and once again home, but post the surgical experience.
Each hospital was blinded and each variable was aligned to the hospital, using an “X” to identify if the variable was a problem. It was through this research, we identified the variables most prevalent to healthcare providers. There you have the three solutions in our ERASE SSI program.
Solution 1: Engage the Patient
We identified a kit with products needed for pre-surgical bathing at home with consumer friendly instructions, easy-to-use tools to help the patient navigate through the pre-surgery process. We also included the push out video from emmi solutions® to further help the patient once they were home. We know from research that a patient forgets 80 percent of what the healthcare provider teaches them once they are home. Ready. Set. Prep gives the patient everything they need to prepare prior to the actual surgery.
Solution 2: Close with Confidence
Every hospital that was part of the study had “X’s” concerning closing procedure, whether it was using dirty instruments, gowns, gloves — guilty! With a closing kit color coded to be ALL GREEN, even the plastics, to contrast against the normal operating “blue,” to indicate if the closing process was being executed. With a kit like, Ready. Set. Close, staff uses green products and can rest assure the closing was with clean products versus dirty!
Solution 3: Discharge with Ease
As mentioned, when a patient knows they’re being discharged, it can be hard to get their attention. They’re thinking about going home. It’s no wonder patients can forget what the healthcare provider tells them. The other thing we know is staff is giving patients products to take home and they might be going over how to change their dressings, but often times there wasn’t a process to provide products and instructions in a consumer fashion. The Ready. Set. Recover kit helps fill this gap with the right products, the right instructions, provided at the right time.
Each solution meets a need that was clearly documented and researched by the Center for Transforming Healthcare. The hospitals which followed a systematic, data-driven process came to a deeper understanding of the variables most strongly associated with SSIs. This research and approach led to an estimated cost savings of $3.7 million for the 135 SSIs avoided during the post intervention phase. Guests were enthusiastic and encouraged by the practical solutions based on this data. Yes! Being a solution provider is definitely trendy and hip. Thank you AORN for a platform to launch new innovation.
The Joint Commission. http://www.centerfortransforminghealthcare.org/assets/4/6/SSI_storyboard.pdf. Updated Dec. 22, 2014.
Chief Market Solutions Officer
Sue MacInnes is Medline’s Chief Market Solutions Officer. With more than 30 years of healthcare experience as a clinician, chief executive and thought leader, MacInnes is driving new strategies designed to help Integrated Delivery Network (IDN) systems successfully manage integration, cost, quality, and outcomes as well as patient preference, loyalty and awareness.