Ms Amanda Wood1
1Health Quality and Safety Commission, Wellington, New Zealand
Introduction: Since 2013, the Health Quality & Safety Commission New Zealand has collected orthopaedic surgical site infection (SSI) data for publicly funded hip and knee arthroplasty procedures as part of the Surgical Site Infection Improvement Programme.
Process and outcome measures are captured. By 2019 district health boards (DHBs) had achieved 96-98% compliance for process measures (appropriate timing and dose of antibiotic prophylaxis, and alcohol-based skin antisepsis) and there was a 25% reduction in the median SSI rate. These results, and feedback about the resource required to collect data, led to an evaluation of the programme and introduction of a light surveillance reporting model.
Method: In October 2020, the option to shift to ‘light surveillance’ was implemented. This reduced mandatory data fields from 35 to 5. A review of SSI cases using a standardised investigation tool and a variable life-adjusted display (VLAD) report for early identification of an SSI risk increase was introduced. The findings are shared at quarterly network meetings.
Progress: Fourteen of twenty DHBs shifted to light surveillance. Changes to SSI risk is actively monitored. A DHB survey showed a median time saving of 16 hours each reporting quarter. Use of the investigation tool has enabled DHBs to identify risks and opportunities for improvement.
Conclusion: The reduction in resource requirement for data collection provided by the shift from full to light surveillance has freed up time to focus on in-depth review of SSI cases. The SSI investigation tool and VLAD report provides a systematic approach to monitoring results.
Biography: Amanda Wood is a specialist with the Infection Prevention and Control Team at the Health Quality and Safety Commission.