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Quality Outcomes

Surgical Care Improvement Processes of Care Measures

Results are from patients who had overnight hospital stays from April 1, 2012 through March 31, 2013.

Surgical Care Improvement Processes of Care Measures1                                                     

St. Clair results National results
Percent of surgery patients who were asking heart drugs called beta blockers before coming to the hospital, who were kept on the beta blockers during the period just before and after their surgery.

98%

97%

Percent of surgery patients who were given an antibiotic at the right time (within 1 hour before surgery) to prevent infection.
Higher percentages are better

99%

99%

Percent of surgery patients who were given the right kind of antibiotic to help prevent infection.
Higher percentages are better

99%

99%

Percent of surgery patients whose preventive antibiotics were stopped at the right time (within 24 hours after surgery).
Higher percentages are better

99%

98%

Percent of all heart surgery patients whose blood sugar (blood glucose) is kept under control in the days right after surgery.
Higher percentages are better

100%

96%

Surgery patients whose urinary catheters were removed on the first or second day after surgery.

100%

97%

Percent of surgery patients who got treatment at the right time (within 24 hours before or after surgery) to help prevent blood clots after certain types of surgery.
Higher percentages are better

99%

98%

1Source:  U.S. Department of Health and Human Services

 

 

Beta Blocker

What are we measuring?

How frequently patients who regularly take beta blocker medications receive a dose before or during their surgery.

Why is this important?

Several scientific studies have shown the importance of keeping patients’ heart rate in a normal range during surgery. Discontinuation of beta blocker medications in patients who regularly take them can lead to rapid and undesirable increase in heart rate during surgery.

How are we doing?

St. Clair’s outcomes parallel the national average. Our anesthesia team understands the importance of uninterrupted beta blocker therapy and works with the surgeon to evaluate each patient’s need for therapy.

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Antibiotic on Time

What are we measuring?

How often patients undergoing surgery are administered an antibiotic within one hour before the incision is made.

Why is this important?

Studies have shown that the lowest incidence of post-operative infection is associated with antibiotic administration during the one hour prior to the surgical incision being made.

How are we doing?

St. Clair’s outcomes are not as strong as the national results. Our team of operating room nurses, surgeons and anesthesiologists continue to analyze and refine our processes with the goal of having 100 percent of our surgical patients receive an antibiotic within an hour prior to surgery.

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Right Kind of Antibiotic

What are we measuring?

How often surgical patients receive the antibiotic current guidelines recommend as being most appropriate for their operation.

Why is this important?

When administering antibiotics to prevent infection, it is important to use a medication that is safe, cost-effective, and is effective against most of the bacteria known to cause surgical site infections.

How are we doing?

St. Clair’s outcomes parallel the national average. Our surgeons have worked with infection prevention physicians to consistently select the antibiotic best suited for each patient’s operation.

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Antibiotic Stopped in Time

What are we measuring?

How frequently antibiotics are stopped within 24 hours of the end of surgery

Why is this important?

When administering antibiotics to prevent infection, it is important that the medication is present in the body’s blood and tissues throughout the operation.  However, administration of antibiotics for more than a few hours after the incision is closed offers no additional benefit to the surgical patient. 

How are we doing?

St. Clair’s outcomes are above the national results.  Our team of surgeons and surgical recovery nurses understand the importance of timely discontinuation of antibiotics following surgery.

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Controlled Blood Sugar in Open Heart Surgery

What are we measuring?

How often open heart surgery patients have a controlled morning blood glucose level in the days following surgery.

Why is this important?

Several studies have confirmed that patients with higher than normal blood sugar levels in the immediate post-operative period are more likely to develop a surgical site infection and other complications.

How are we doing?

St. Clair’s outcomes are significantly better than the national results. The Hospital’s Heart Center uses established protocols to closely manage blood glucose levels in the first days after surgery.

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Foley Removal

What are we measuring?

How often patients with urinary catheters have them removed by the second day after surgery.

Why is this important?

It has been well–established that the risk of developing a urinary tract infection increases with the length of time the urinary catheter is present.

How are we doing?

St. Clair’s outcomes are above the national results.  Our surgeons have developed physician order sets that routinely require the removal of urinary catheters by the end of the second day following surgery.

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Received Medicine to Prevent Clots

What are we measuring?

How frequently surgical patients receive medication within a day after surgery to decrease their risk of developing blood clots. 

Why is this important?

Surgical patients are immobile during surgery, sometimes for long periods of time.  This is associated with a high risk of developing a blood clot in a deep vein of the leg or in the lungs. 

How are we doing?

St. Clair’s outcomes are above the national results.  Physician led teams have developed protocols for assessing each patient’s risk and determining if they can safely receive therapy to prevent blood clots.

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