MHA Keystone: Surgery

MHA Keystone: Surgery focuses on eliminating surgical-site infections, preventing defects in care (including wrong-site surgery and retained foreign objects), eliminating mislabeled specimens and improving the safety and teamwork climate for the roughly 420,000 surgeries performed in MHA Keystone: Surgery hospitals annually. The collaborative aims to reduce the 5 percent rate of complications and 5 percent rate of mortality as a result of surgical complications, which cost an estimated $250 million nationally each year.

A key element to impacting culture change is improving communication among members of the surgical team. One method is conducting briefings before surgery to confirm the correct patient is in the operating room, to verify the surgical site, to ensure the proper equipment is accessible and to outline possible complications. Debriefings are conducted immediately following the procedure to identify defects and discuss the patient’s future needs, ensuring a smooth transition to postoperative care. From January to December 2010, participating hospitals completed 389,751 briefings and 378,668 debriefings, accounting for roughly 91 percent of the surgeries in participating hospitals during that time period. In addition, MHA Keystone: Surgery collaborates with the MHA PSO to use the surgical data to track outcomes and monitor the effectiveness of briefings and debriefings in reducing harm.

MHA Keystone: Surgery teams are collecting data on the safe handling of surgical specimens and are working toward improvements in their processes to decrease the number of defects, reduce the risk of misdiagnosis and diminish the potential need for repeat surgery. From May 2010 to May 2011, the surgical specimen defect rate decreased more than 50 percent, from 3.18 percent to 1.46 percent.

In addition, the October 2010 MHA Keystone: Surgery workshop was attended by more than 300 clinicians and the collaborative was highlighted in the national OR Manager publication in December, August and September.