The purpose of this project was to explore opportunities for enhancing the detection and surveillance of inpatient-acquired surgical site infections (SSIs) for four target procedures—herniorrhaphy, coronary artery bypass graft (CABG), and hip and knee arthroplasty (including primary total arthroplasty, primary hemiarthroplasty, and revision procedures). Four delivery systems came together in order to provide the most representative results and generalizable tools. Collaborating delivery systems include Denver Health (a safety-net hospital located in Denver, CO), Intermountain Healthcare (a large, nonprofit, integrated delivery system based in Salt Lake City, UT), and the Salt Lake City Veterans Affairs Medical Center (a VAMC hospital located in Salt Lake City); representativeness was further extended by including the Vail Valley Medical Center (Vail, CO), a Denver Health partner.
One key activity involved developing and testing a computer-assisted algorithm for retrospective assessment of medical records, laboratory test results, and patient demographic data to identify electronically patients with potential SSIs. The plan for, results, and implications of this work is presented in Chapter 2.
A second primary activity of our work involved screening an expanded set of SSI risk factors to consider in exploring, monitoring, and predicting SSIs. The approach for screening additional risk factors, analytic results, and recommendations are presented in Chapter 3.
Chapter 4 provided insights from two target audiences—surgeons and infection prevention nurses—using qualitative research methods to inform Chapter 2 and Chapter 3 activities as well as dissemination and outreach with the results of our work (see Chapter 5).