QI program lowers complication rates in 5 years : 4 project insights

The results of a quality improvement project at Palo Alto, Calif-based Stanford Bariatric, an accredited weight loss surgery center, showed accreditation standard improved quality of care while the center continued to build surgical volume through a multiyear quality improvement project starting in 2013.

Stanford's bariatric surgery program identified areas of improvement by reviewing the metabolic bariatric surgery accreditation and quality improvement program semiannual report. The risk-adjusted report contains participating centers' combined outcomes and center-specific data.

Here are four insights from the project:

1. To reduce surgical site infections, the improvement project committee educated personnel about the improvement initiative and followed up with team members about surgical procedures. In monthly meetings, the entire bariatric program staff reviewed outcomes data, identified the root causes of SSIs that occurred and discussed how to prevent them.

2. From 2013 to 2017, the number of bariatric operations performed annually at Stanford rose from 234 to 438, but complications from surgery decreased.

3. The improvements in surgical outcomes included:

● 30-day readmission dropped from 4.7 percent to 2.1 percent of surgical cases

● Medication reconciliation compliance increased from 83 percent to 100 percent of surgical cases.

● Bleeding decreased from 0.9 percent to zero.

● Urinary tract infections were reduced from 1.1 percent to zero.

● SSIs were reduced from 2.5 percent to 0.5 percent.

4. To lower the readmission rate, the project team created a policy where nurses would contact each patient by phone after discharge, allowing staff to identify problems and schedule follow-up appointments before a potential complication became severe.

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