Back row: Kelsey Portz, Patty Williams, Carla Parker, Naomi Moose
Front row: Ashley Wright, Margaret Shaffer
With many surgeries being outpatient or inpatients being discharged within a few days after surgery, hospitals and ambulatory surgery centers can have a hard time identifying postop complications. A process was created between a hospital and the clinic where patients were seen for their postop visits for infection control surveillance, to identify postop infections. An opportunity to identify other postop complications or events was identified and merged with the surgical surveillance process. In this program, for three months postop surgeons’ staff ask every surgical patient a series of questions to identify postop complications. When the patient is roomed for the postop, visit the clinical staff ask patients about:
- Urgent care, emergency room, or hospital visits since their surgery
- Bleeding or blood clot issues
- Medication reactions
- Infection or wound healing issues or concerns
- Swallowing issues
This information is reviewed by the surgeon who may need to provide treatment or interventions and is used for surveillance.
Patient Safety staff from the hospital where the surgery was performed review the information and if a patient answered yes, a more thorough chart review is done to determine if there was a postop complication. The data is reported to the Patient Safety Committee and or the Infection Control Committee, as well as being available to the Surgical department monthly, and is used to identify trends with infections, wound healing, postop deep vein thrombosis (DVT) and other issues. The hospital has both an operating room—where patients are admitted to the hospital, placed in extended recovery, or are discharged from the post anesthesia care unit (PACU)—and an Ambulatory Surgery Center. The same process is used for both.
In the first 10 months of 2022, patients were asked the questions 16,715 times. For every surgical patient, on average they were asked the questions 3.35 times. One in every 26 postop patients responded with a yes to one or more of the questions. One in every 160 patients who were asked the questions had a postop complication or issue that was reported to the appropriate committees and departments for follow up. One in every 522 patients who answered the questions was found to have a serious event.
Although this process is time intensive, it shows the organization’s commitment to patient safety and to identifying issues and improving patient outcomes. What started as a creative idea to capture surgical site infections has blossomed into a unique way to identify postop complications or issues that otherwise probably would have not been identified.