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​BC Patient Safety & Quality Council

The Safer Healthcare Now! SSI Getting Started Kit (2014) is making a huge impact on safe surgical care. Surgical teams can take the information from the kit and run with it. Implementing safe surgical care varies from setting to setting and the surgical team has to decide how to do it and who does what. "The Getting Started Kit provides the evidence, but the how is what we leave up to the frontline teams, because that is where the wisdom is," says Marlies van Dijk, (former) Director, Clinical Improvement (BC Patient Safety & Quality Council).

Preventing surgical site infections is a priority across British Columbia and culture is considered an essential factor to reduce harm. The BC Patient Safety & Quality Council is coordinating the National Surgical Quality Improvement Program (NSQIP) – a surgeon-led initiative where 24 hospitals are using a rigorous measurement tool to look at risk-adjusted surgical outcomes to help foster that culture change. The initiative focuses on the hospital or unit as a learning system and continually looks at process and outcome data to drive improvement.

As most infections appear post-discharge, the cornerstone of the program is a 30-day post-operative chart review and follow-up with surgical patients. The NSQIP analysis of 19 out of 24 hospital sites in British Columbia identified areas for improvement and indicated there was a potential for saving between 7,700 to 31,000 patient days per year across the province.

The BC Patient Safety & Quality Council is building a reliability culture to reduce SSI. The successful strategies focus on frontline and clinical ownership. Shifting ownership and decision-making to the frontline is essential to improving results.

"By looking at the adaptive side of clinical care we can bring our SSI rates under control," says Marlies. "We need to talk about safe surgical care differently and focus on culture, leadership and engagement. We have an obligation to our patients to ensure that best practices are being provided and this approach is very doable." (Safer Healthcare Now! One Pager, 2014)