The C
USP
of Im
prov
ing
Colo
rect
al Su
rger
y Out
com
esTh
e CUS
P of
Impr
ovin
g Co
lore
ctal
Surg
ery O
utco
mes
J.W
. Cro
mwe
ll, MD
, M. B
eldin
gJ.W
. Cro
mwe
ll, MD
, M. B
eldin
g --Sc
hmitt
, RN,
BSN
, CPH
Q, M
.K. B
rook
s, RN
, MSN
, CPH
QSc
hmitt
, RN,
BSN
, CPH
Q, M
.K. B
rook
s, RN
, MSN
, CPH
Q Un
ivers
ity o
f Iow
a Ho
spita
ls an
d Cl
inics
, Iow
a Ci
ty, Io
wa
Back
grou
ndBa
ckgr
ound
Goals
Goals
Less
ons L
earn
edLe
sson
s Lea
rned
N
aon
ally,
app
roxi
mat
ely
one
mill
ion
peop
le d
evel
op a
se
rious
com
plic
aon
as a
resu
lt of
surg
ery
each
yea
r
Adul
t col
orec
tal s
urge
ry S
SI a
nd re
adm
issio
n ra
tes w
ere
subs
tan
ally
hig
her t
han
our p
eers
in N
SQIP
, NHS
N a
nd
Hosp
ital C
ompa
re
Se
ptem
ber 2
012—
UIH
C ag
reed
to p
arci
pate
in th
e Ag
ency
for H
ealth
care
Res
earc
h an
d Q
ualit
y (A
HRQ
) Su
rgic
al U
nit‐
base
d Sa
fety
Pro
gram
(SU
SP) t
o re
duce
su
rgic
al si
te in
fec
ons (
SSI)
and
othe
r sur
gica
l co
mpl
ica
ons i
n co
lore
ctal
surg
ery
Tw
o‐ye
ar c
omm
itmen
t
Ove
r 200
hos
pita
ls pa
rci
pang
To
ach
ieve
sign
ifica
nt re
duc
ons i
n su
rgic
al si
te in
fec
on
and
surg
ical
com
plic
aon
rate
s
To a
chie
ve si
gnifi
cant
impr
ovem
ents
in sa
fety
cul
ture
To im
plem
ent t
he C
ompr
ehen
sive
Uni
t‐ba
sed
Safe
ty
Prog
ram
(CU
SP) m
etho
dolo
gies
CUSP
app
roac
h ca
n be
app
lied
to a
ny sa
fety
or
infe
con
rela
ted
oppo
rtun
ity
CU
SP is
a st
ruct
ured
stra
tegi
c fr
amew
ork
for s
afet
y th
at in
tegr
ates
com
mun
ica
on, t
eam
wor
k, a
nd
lead
ersh
ip to
cre
ate
and
supp
ort a
cul
ture
of p
aen
t sa
fety
that
can
pre
vent
har
ms
Fr
eque
nt m
eeng
s kep
t eve
ryon
e co
nnu
ously
info
rmed
an
d en
gage
d
Real‐
me
iden
fica
on o
f def
ects
allo
wed
for s
tep‐
wise
be
st p
rac
ce im
plem
enta
on
Bo
wel
pre
ps m
ake
a diffe
renc
e!
Impr
ovem
ent M
etho
dolo
gyIm
prov
emen
t Met
hodo
logy
Resu
ltsRe
sults
SSI r
ate
for S
USP
pilo
t sur
geon
s: 8
% a
bsol
ute
redu
con
. Th
is eq
uate
d to
six
few
er S
SIs
3
few
er D
eep/
Org
an S
pace
and
3 fe
wer
Sup
erfic
ial
SS
I rat
e fo
r SU
SP p
ilot s
urge
ons i
s 12.
76%
ver
sus n
on‐
SUSP
pilo
t sur
geon
s’ ra
te o
f 35.
48%
SSI r
ate
for S
USP
pilo
t surgeon
s in
the fir
st q
uart
er o
f 20
14 w
as 6
.38%
(N
o SS
I in
Janu
ary
or M
arch
201
4)
Re
adm
issio
ns d
ue to
SSI
wer
e re
duce
d 36
% fr
om
base
line
to e
nd o
f firs
t yea
r and
51%
from
bas
elin
e to
la
st q
uart
er
Ho
spita
l Com
pare
resu
lts im
prov
ed fr
om “
Wor
se th
an
U.S.
Na
onal
Ben
chm
ark”
to “
No
diffe
rent
than
U.S
. N
aon
al B
ench
mar
k”
Sa
ved
$180
,000
in e
xtra
pa
ent c
osts
95%
of S
USP
pa
ents
had
a S
urgi
cal S
afet
y Ch
eckl
ist
com
plet
ed
Inte
rven
tions
Inte
rven
tions
