Surgical safety culture reduces post-op infections

A culture of safety in surgical units appears to significantly reduce surgical site infections (SSIs) after colon operations, according to a study published online by the Journal of the American College of Surgeons.

Of 12 safety culture factors studied, teamwork across units most consistently reduced SSI infections, researchers found. Positive impacts ranged from 24 percent to 49 percent, according to an announcement from the American College of Surgeons.

In the announcement, lead study author Martin Makary, M.D., of the Johns Hopkins University School of Medicine, defined safety culture as "the organizational characteristics of delivering great care" and the attitude of "how we do things around here."

Feedback and communication after errors like that found in teaching hospitals had a positive impact as high as 79 percent at some hospitals and as low as 21 percent in others--the widest range reported among 12 safety culture factors researched, according to the announcement.

In all, 10 of the 12 safety culture factors influenced SSI rates after colon operations. The others were:

  • Overall perceptions of patient safety
  • Organizational learning
  • Teamwork within units
  • Management support for patient safety
  • Communication openness
  • Supervisor and manager expectations of actions promoting safety
  • Non-punitive response to error
  • Frequency of events reported

Staffing and the handoff of care from one team to another were not shown to affect SSI rates, according to the announcement.

"Anybody who cares for patients knows that a hospital's culture contributes to a patient's outcome, and this study affirmed that observation," Makary said.

Earlier this week the National Patient Safety Foundation (NPSF) issued a report looking more broadly at patient safety and medical errors. It concluded that healthcare organizations must take a pervasive, systematic approach and develop a culture of safety to combat medical errors and adverse events, FierceHealthcare reported.

Meanwhile, a separate study highlighted another surgical infection risk: Surgical staff enter and exit operating rooms so frequently that they could let germs in. In 77 of 191 cases, doors were open long enough to compromise the positive air-pressure systems that are supposed to reduce the flow of outside air into the OR environment.

To learn more:
- see the study abstract
- read the announcement