Discussion Board 6
The Surgical Care Improvement Project (SCIP) and the Training Strategies needed for all
Healthcare Professionals to Reduce Surgical Errors
Partners involved in the surgical care improvement project (SCIP) which is a national
quality partnership of organizations that are interested in improving surgical care by reducing
surgical complications have noted that, “postoperative infection is a major cause of patient
injury, mortality and health care cost” (Stulberg et al., 2010, p.2480) and an estimated “2.6
percent of nearly 30 million operations are complicated by surgical site infections each year”
(Stulberg et al., 2010, p.2480) Infection rates of up to 20 percent are reported for certain types of
operations. Each infection is “estimated to increase a hospital stay by an average of seven days
and add over $3,000 in charges” (Stulberg et al., 2010, p.2480). Appropriate administration of
“prophylactic” (Stulberg et al., 2010, p.2480) antibiotics is stated to be an effective method of
preventing postoperative infections.
The Surgical Care Improvement Project (SCIP) partnership’s goal is to reduce surgical
complication in the United States by “25 percent” (Stulberg et al., 2010, p.2481) and to achieve
this reduction, these SCIP partners believe that a meaningful reduction in complications requires
that surgeons, anesthesiologists, perioperative nurses, pharmacists, infection control
professionals, and hospital executives must all work together to make surgical care improvement
a priority. In order to achieve compliance with SCIP, a retrospective cohort study was conducted
by using data from “Premier Inc's Perspective Database which is an inpatient administrative
database that is developed and maintained by Premier Inc in North Carolina” (Stulberg et al.,
2010, p.2482). This database contained data from the SCIP which was used to determine the
effectiveness of self-reported adherence to 6 publicly reported SCIP infection-prevention
measures in predicting postoperative infection (Stulberg et al., 2010). The SCIP data used in the
study examined performance data of 398 hospitals that have undergone all the same quality
assurance and data validation checks as the data reported on “the Hospital Compare Website”
(Stulberg et al., 2010, p.2483).
The results of this study showed:
3996 documented postoperative infections. The S-INF composite process-of-care
measure predicted a decrease in postoperative infection rates from 14.2 to 6.8 per 1000
discharges (adjusted odds ratio, 0.85; 95% confidence interval, 0.76-0.95). The S-INF-
Core composite process-of-care measure predicted a decrease in postoperative infection
rates from 11.5 to 5.3 per 1000 discharges (adjusted odds ratio, 0.86; 95% confidence
interval, 0.74-1.01), which was not a statistically significantly lower probability of
infection. None of the individual SCIP measures were significantly associated with a
lower probability of infection. (p.2483)
Based on this result, it was concluded that “hospitals in the Premier Inc Perspective Database
reporting SCIP performance adherence, measured through a global all-or-none composite
infection-prevention score was associated with a lower probability of developing a postoperative
infection” (Stulberg et al., 2010, p.2483). However, adherence reported on individual SCIP
measures, which is the only form in which performance is publicly reported, was not associated
with a significantly lower probability of infection” (Stulberg et al., 2010, p.2483). It is, therefore,
safe to say that, the SCIPs project has been shown to impact patient outcomes, teamwork among
nurses, patient education, and the entire healthcare profession positively but when SCIP
measures are not followed, the consequences are catastrophic.
As a healthcare administrator in charge of reducing surgical errors in my organization,
my training strategies would be to first ensure that all my healthcare providers are practicing
safety measures and are also properly documenting and charting patients’ information from
medication list, blood temperature, allergies, and so on in the electronic system right from the
patients entry to the hospital and after discharge. This is important because, when healthcare
providers like nurses, protect their patients from surgical site infection or surgical complications
after surgery they are making sure that these patients are protected from harm but if they are
missing any safety measures in their chart and an error occurs due to this, it would greatly impact
the hospitals reimbursement and also compromise the organizations financial stability when
medical claims are denied.
Training and Development Activities needed to change the Culture of the Hospital and the
Impact of Human Resources Management Activities to help reduce patient care errors.
The training and development activities are the most “important activities” (Pynes &
Lombardi, 2011, p.289) of human resources management (HRM) as it helps healthcare
organizations to reach their goals which would also help reduce patient care errors. For example,
HRM can develop a training curriculum for the healthcare workers after assessing their training
needs and it is important that these training and development activities are “fully integrated with
the organization’s strategic focus and strategic human resources management systems” (Pynes &
Lombardi, 2011, p.317). The training and development activities that I would implement to help
change the culture of the hospital is to make system adjustments that would help transform the
hospital environment for patients and all health workers. These adjustments can be in form of
designing an error-reporting system that would include feedback to those involved which would
serve as a learning tool for others to learn from and prevent similar events in the future because
“surgical errors are under scrutiny in health care as part of ensuring a culture of safety in which
patients receive quality care” (Hemingway, O'Malley & Silvestri, 2015, p. 405). Healthcare
organizations use safety measures to compare their performance against other industry
benchmarks. To understand patient safety issues, health care providers must have standard
processes in place that would help “analyze and evaluate the quality of the care they provide”
(Hemingway, O'Malley & Silvestri, 2015, p. 404). Other activities to be implemented would be
to improve communication skills among hospital staff, implement team strategies that would
help complete work more efficiently, and develop a safety culture that would extend across all
hospital settings. The Bible is not silent in regard to providing healthcare quality and safety to
patients as seen in the scripture that says: “And whatsoever ye do do it heartily, as to the Lord,
and not unto men” (Colossians 3:23, King James Version).
WORD COUNT: 1007
References
Hemingway, M. W., O'Malley, C., & Silvestri, S. (2015). Safety culture and care: A program to
prevent surgical errors: The official voice of perioperative nursing. AORN
Journal, 101(4), 404-415.
doi:http://dx.doi.org.ezproxy.liberty.edu/10.1016/j.aorn.2015.01.002
Pynes, J., & Lombardi, D. N. (2011). Human resources management for health care
organizations: a strategic approach. San Francisco: Jossey-Bass.
Stulberg, J. J., Delaney, C. P., Neuhauser, D. V., Aron, D. C., Fu, P., & Koroukian, S. M. (2010).
Adherence to surgical care improvement project measures and the association with
postoperative infections. Jama, 303(24), 2479-2485.
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