Surgical Care Improvement Project (SCIP)

SCIP: A Partnership for Better Care

The Surgical Care Improvement Project (SCIP) is a national quality partnership of organizations com­mitted to improving the safety of surgical care through the reduction of postoperative complications. The ultimate goal of the partnership is to save lives by reducing the incidence of surgical complications by 25 percent by the year 2010.

Partners in SCIP believe that a meaningful reduction in complications requires that surgeons, anesthesiologists, preoperative nurses, pharmacists, infection control professionals and hospital executives work together to make surgical care improvement a priority.

The SCIP partnership seeks to substantially reduce surgical mortality and morbidity through collaborative efforts. Come join us in saving lives and improving patient care!

What is at Stake for the Public’s Health

Research shows that a significant percentage of the nearly 30 million operations performed in the United States each year results in preventable, often life threatening complications. The Institute of Medicine, in its groundbreaking report To Err Is Human, highlighted a study of more than 44,000 operations at a large medical center from 1977 to 1990. It revealed that 5.4 percent (more than 2,400 patients) suffered complica­tions, nearly half of them attributable to error.

A 2003 study published in the Journal of the American Medical Association found that postoperative compli­cations accounted for up to 22 percent of preventable deaths among patients, depending on the complica­tion. The same study looked at 18 types of medical injuries during hospitalization and found those events accounted for 2.4 million additional hospital days and $9.3 billion in additional charges each year.

Preventing Surgical Complications

Although some surgical complications are unavoidable, surgical care can be improved through better adherence to evidence-based practice recommendations and by giving more attention to designing systems of care with redundant safeguards.

For example, research shows that delivering antibiotics to a patient within one hour prior to beginning surgery can dramatically cut surgical site infection rates. In other examples, application of the National Surgical Quality Improvement Program (NSQIP) within the VA resulted in a 27 percent reduction in mortality re­lated to surgery. Hospitals participating in the National Nosocomial Infections Surveillance (NNIS) system of the CDC have shown reductions of up to 44 percent in device-associated complications and surgical site infec­tion rates. The national network of Medicare quality improvement organizations (QIOs), working under contract to CMS, recently conducted a surgical infec­tion prevention collaborative that effectively reduced SSIs by 27 percent at 56 centers across the country.

SCIP Process and Outcome Measures

Infection

• SCIP INF 1: Prophylactic antibiotic received within one hour prior to surgical incision
• SCIP INF 2: Prophylactic antibiotic selection for surgical patients
• SCIP INF 3: Prophylactic antibiotics discontinued within 24 hours after surgery end
• SCIP INF 4: Cardiac surgery patients with controlled 6 a.m. postoperative blood glucose
• SCIP INF 6: Surgery patients with appropriate hair removal
• SCIP INF 7: Colorectal surgery patients with immediate postoperative normothermia

VTE

• SCIP VTE 1: Surgery patients with recommended venous thromboembolism prophylaxis ordered
• SCIP VTE 2: Surgery patients who received appropriate venous thromboembolism prophylaxis within 24 hours prior to surgery to 24 hours after surgery
• SCIP VTE 3: Intra- or postoperative pulmonary embolism (PE) diagnosed during index

CFMC and Colorado Hospitals

The Colorado Foundation for Medical Care will provide technical and professional guidance and support for the Surgical Care Improvement Project (SCIP) in Colorado. Hospitals have already been selected to participate in the project and quarterly WebEx sessions will be scheduled and announced soon.

Participation supports your hospital’s involvement with other quality improvement initiatives such as:

• Hospital Quality Alliance
• JCAHO Core Measures
• IHI 5M Lives Campaign

Participation in the SCIP Project Involves:

• Collecting and submitting data to QualityNet via CART or other authorized tool.
• Attending monthly WebEx conference calls and share best practices and implementation strategies.
• Making system changes based on your quality improvement data.

Participation Hospitals will benefit from this project in many ways including:

• Strengthen your efforts for Pay for Performance
• Gain recognition as a leader both locally and nationally.
• Opportunities to network with peers and learn best practices.
• Receive technical assistance with the free CMS tool, CART.
• Strengthen partnerships with professional organizations, such as American College of Surgeons, American College of Cardiac and Thoracic Surgeons, American Society of Anesthesiologists, Association of Preoperative Registered Nurses
• Educational webexs and conference calls.
• Free resources and tools.
• Data analysis and reports.

Hospitals will be addressing a common set of indicators by collecting, entering and submitting data to the QIO Clinical Warehouse via CART (CMS Abstraction and Reporting Tool) and/or an authorized vendor.

For more information, visit and bookmark the SCIP Partnership’s website at www.MedQIC.org/scip or contact Hilarie Olson, Quality Improvement Specialist, at 303.875.6975 or holson@coqio.sdpsorg or Michelle Mills, Project Director, at 303.847.1727 or mmills@coqio.sdps.org.