Improving outcomes in elective colorectal surgery

A single-institution retrospective review

Lindsay K. Rumberger, Debra Vittetoe, Lorene Cathey, Harriet Bennett, Robert Heidel, Brian Daley

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Our hospital, a Tennessee Surgical Quality Collaborative (TSQC) member, adopted a statewide colorectal care bundle intended to reduce surgical site infections (SSI) in elective colorectal cases. The bundle includes proper antibiotics/dosing, normoglycemia, normothermia, supplemental oxygen six hours postoperatively, and early enteral nutrition. A single-institution retrospective study of our National Surgical Quality Improvement Program (NSQIP) database for the rates of SSI before and after the colorectal bundle.We compared our SSI rates to TSQC hospitals as well as NSQIP datasets. Because of low case numbers in the NSQIP data, National Healthcare Safety Network (NHSN) data collected at our institution was used to compare our colorectal SSI before and after our colorectal bundle. From January 2010 to December 2011, 188 patients underwent nonemergent colorectal surgery in the NSQIP data. Of these, 5.4 per cent (10/188) developed superficial SSIs. During this same time, the rate of the TSQC superficial SSI was 7.1 per cent and NSQIP was 7.8 per cent. From January 2013 to October 2014, after the colorectal bundle started, 76 patients in NSQIP underwent nonemergent colorectal surgery. Of these, 6.5 per cent (5/76) developed superficial SSI, compared with 5.5 per cent in TSQC and 5.5 per cent in NSQIP. NHSN data showed a prebundle rate of 11 per cent and a postbundle rate of 3.5 per cent (P < 00.1, x2). After adopting a colorectal bundle aimed at reducing SSIs, we did not improve our SSI rates in NSQIP; however, our NHSN data demonstrated considerable improvement. Differences in data collection may affect SSI rates, and ultimately "quality" based reimbursement. Implementation of the bundle did improve outcomes in colorectal surgery.

Original languageEnglish (US)
Pages (from-to)325-330
Number of pages6
JournalAmerican Surgeon
Volume82
Issue number4
StatePublished - Apr 1 2016

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Surgical Wound Infection
Colorectal Surgery
Quality Improvement
Delivery of Health Care
Safety
Patient Care Bundles
Enteral Nutrition
Retrospective Studies
Databases
Oxygen
Anti-Bacterial Agents

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Improving outcomes in elective colorectal surgery : A single-institution retrospective review. / Rumberger, Lindsay K.; Vittetoe, Debra; Cathey, Lorene; Bennett, Harriet; Heidel, Robert; Daley, Brian.

In: American Surgeon, Vol. 82, No. 4, 01.04.2016, p. 325-330.

Research output: Contribution to journalArticle

Rumberger, LK, Vittetoe, D, Cathey, L, Bennett, H, Heidel, R & Daley, B 2016, 'Improving outcomes in elective colorectal surgery: A single-institution retrospective review', American Surgeon, vol. 82, no. 4, pp. 325-330.
Rumberger, Lindsay K. ; Vittetoe, Debra ; Cathey, Lorene ; Bennett, Harriet ; Heidel, Robert ; Daley, Brian. / Improving outcomes in elective colorectal surgery : A single-institution retrospective review. In: American Surgeon. 2016 ; Vol. 82, No. 4. pp. 325-330.
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