Surgical Site Infections :: Quality Measures :: Nationwide Children's Hospital

Surgical Site Infections (SSI)

What is a surgical site infection?

A surgical site infection (SSI) is a complication resulting from surgery. An infection may develop following any kind of surgery. SSIs can develop when germs get in the surgical wound.

We measure SSIs for surgeries involving the heart, back, and brain.

Why do we measure?

  • SSIs cause complications in recovery.

  • SSIs may cause delayed healing resulting in a longer hospital stay for patients.

How do we measure?

  • As part of the CHCA group reduction effort, we collect information on proper timing and doses or antibiotics and proper pre-surgical skin preparation.

  • SSIs are calculated as the number of infections per 100 surgical procedures.

  • An infection is considered related to surgery if it occurs within 30 days following surgery (or one year if an implant is involved).

How are we improving?

  • We implemented "Operation Takeoff" as a method to reduce surgical site infections.

  • Once the checklist is complete, the surgery is "cleared for takeoff."

We report our data using what is known as a control chart. There are four elements on the chart. 1) The blue diamonds: these are the actual data points for each month. They depict the event rate as defined on the vertical axis. 2) and 3): The dotted red lines: these are the upper and lower control limits. They are scientifically calculated to represent the statistical range within which normal random variation occurs in a stable system. 4) The solid red line. This is the average of the blue diamonds for that time frame. As long as the blue diamonds are within the dotted red lines, the system being measured is a stable one. There are certain patterns of blue diamond configuration (e.g. diamonds outside the control limits), that mean something in the system has changed. This is called special cause variation and will usually involve a deeper investigation as to why the new pattern of variation. Each control chart contains an arrow which indicates the desired change direction. For most harm events, the desired direction is down (i.e. less harm is better). For other measures (compliance rates, days between harm events) the desired direction is up.

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000