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GME Quality and Safety Bonus Program

Surgery Quality and Safety Homepage


Resident Champion: Alicia Heelan Gladden, MD

Faculty Champion: Ashley Vavra, MD

Metric: Surgical Site Infections (instead of Hospital-Acquired C-Diff All-Program Metric)

Surgical site infection (SSI) is a costly and morbid complication after surgery. In some cases, it can be treated with outpatient wound care and antibiotics but it is also a common cause of prolonged hospital stay, readmission and unplanned return to the operating room. A modest reduction in SSIs has resulted from institution of standardized perioperative care measures and care bundles. The SSI rate at University of Colorado Hospital (UCH) is consistently above the national standard in the American College of Surgeons National Surgery Quality Improvement Program (NSQIP) database. In fact, UCH has had a risk-adjusted SSI rate above national baseline for all but two quarters since onset of participation in July 2013, with a risk-adjusted rate of 2.87% last quarter (population rate of 2.57%). In response to this elevation, UCH has developed a surgical site prevention task force and a common perioperative bundle was implemented in 2016 on select surgical services such as vascular, colorectal and thoracic surgery. However, to date, participation by most services in the Department of Surgery has not been achieved and compliance has been variable. Since several components of the bundle are specifically impacted by resident engagement and involvement, we propose that a program-specific bonus for surgical residents who participate in the perioperative SSI reduction bundle would improve compliance and reduce the UCH SSI rate.

Goal: Compliance with the SSI bundle for participating divisions within the department of surgery at the University of Colorado Hospital/UC Anschutz Campus. Intervention will consist of education of residents regarding use of preexisting UCH pre-surgery (SSI bundle) orderset, prep by nursing staff only and gown/glove protocol applicable for colorectal.

Tier 1- $125

  • 75% compliance

Tier 2- $250

  • ​85% compliance