An apparent lack of correlation between compliance with Surgical Care Improvement Program measures and the infection rates they're intended to reduce has raised doubts about the program's usefulness.
With funding from the U.S. Department of Veterans Affairs, a team of researchers reviewed outcomes from 61,099 surgeries at 112 of the system's hospitals nationwide between 2005, when the VA adopted the data collection and reporting program, and 2009.
According to the study, presented at the American Surgical Association's annual meeting earlier this month, surgical site infection rates remained relatively unchanged at an average 6.2%, even as compliance with SCIP's infection prevention measures rose over the course of 5 years.
During the study period, SCIP required hospitals to monitor the following infection prevention factors for surgical patients:
proper selection of prophylactic antibiotics,
antibiotic administration within 1 hour of incision,
antibiotic discontinuation within 24 hours of closing,
appropriate pre-operative hair removal, and
normothermia maintained for colorectal patients. (This measure has since been expanded to all patients having surgery under general or neuraxial anesthesia for 60 minutes or more).
The researchers were not able to conclusively link improved compliance with any of the 5 measures to reduced SSI rates on either a patient or hospital level.
"SCIP adherence is not informative to third-party payers, administrators, or patients," says Mary T. Hawn, MD, the study's lead author and chief of gastrointestinal surgery at the University of Alabama Birmingham Medical Center, in a published report. "The policy of continued SCIP measurement for public reporting and payment should be reevaluated."
Her findings are similar to a study published by Ohio researchers in the Journal of the American Medical Association last June, which also showed no relationship between SCIP compliance and post-op infection rates.
David Bernard
