Marquette taking lead in surgical patient safety
A recent article in the Wall Street Journal titled, “How to Make Surgery Safer,” focused on surgical safety protocols being implemented at the best hospitals in the United States. While reading the in-depth article, I was struck by the fact that UP Health System Marquette had already implemented most of the safeguards the article spotlighted that were considered to be leading the nation.
Patients having surgery performed at UPHS Marquette will see doctors and nurses, along with a host of support staff, equipment and technology. What they may not see, but is equally important to their care, is the extensive surgical safety infrastructure that is incorporated into each and every surgery performed at the Upper Peninsula’s regional tertiary care center.
The Wall Street Journal article focused on several areas of surgical safety. UPHS Marquette is meeting or exceeding the national standards in the primary surgical safeguard areas focused on in the article.
For instance, in the crucial area of surgical infection, UPHS Marquette can share an amazing success story in the area of total joint replacement with our Total Joint Patient Education Program. This program begins pre-operatively, with extensive “personal tailoring” of education and safety for each patient. Some of the pre-operative education includes:
- Readying the patient’s home for post-surgical recovery.
- Adequate nutrition prior to surgery.
- Blood sugar monitoring before and during the surgery.
- Infection prevention pre- and post-operatively, including skin cleansing
- Physical therapy expectations.
- Occupational therapy expectations.
- Pain management expectations.
- Smoking cessation education.
- Complete preview of the surgery process via a pre-operative meeting with the operating room staff
The result: Of the more than 120 hip or knee patients who recently completed the total joint replacement education at UPHS – Marquette, there have been zero surgical infections. In addition, our most recent 90-day data shows that the overall readmission rate for patients who completed the pre-operative education was less than 1 percent.
According to Center for Disease Control ‘s Surgical Site Infection Report, the surgical site infection rate at UPHS Marquette is consistently lower than expected by the CDC, based on the acuity of the population we serve.
Another surgical safety measure that UPHS Marquette has implemented is our “Prehabilitation Program.” This program consists of providing every elective (both in-patient and outpatient) surgical procedure patient with educational material and instructions that allow patients to best prepare prior to surgery. Some of the pre-operative patient preparation includes:
- Hospital provides “night before” and “morning of” chlorhexidine body wipes and instructions for use, to assure the skin is free of any surface contaminants.
- “Night before” and “morning of” Perox-A-Mint mouthwash.
- Before and after surgery incentive spirometry device to help keep lungs clear.
- To-do list ranging from nutritional guidelines, to exercise/walking instructions, to pneumonia and blood clot avoidance.
There are strict surgical safety protocols in place at UPHS Marquette to guard against errors we do not expect our patients to anticipate, such as wrong-site surgery and surgical objects left in a patient – problems the Wall Street Journal article addressed as still occurring at some hospitals. Regarding such mishaps, our “time out” operating room protocol and strict operating room inventory procedures help ensure staff diligence and patient safety. UPHS Marquette even uses “radio frequency” ID tags, sited in the Wall Street Journal article as a high-tech precaution just gaining widespread use nationally to ensure every instrument, needle and sponge is accounted for.
UPHS Marquette, as a Duke LifePoint hospital, is an affiliate of the Duke Heart Network and the Duke Cancer Network. This direct link to the Duke’s world-renown healthcare delivery resources is bringing a depth of care to the UP that is setting a new quality standard. In addition, we will soon become part of the Duke Infection Control Outreach Network, which will undoubtedly further strengthen our already solid performance in the area of surgical site infection reduction.
Much of our intensive proactive surgical safety net activity takes place behind the scenes, in dozens of diligent initiatives – all resulting in increased surgical success at UPHS – Marquette and our sister LifePoint hospitals in the Upper Peninsula, UPHS Bell and UPHS Portage.
I was heartened while reading the Wall Street Journal article to find that UPHS Marquette is at the forefront of safe surgical standards in so many areas. This effort is testament to our commitment to the U.P. patients that it is our privilege to serve.
Editor’s note: Ed Banos is CEO of UP Health System Marquette.