Analysis of the Surgical Care Improvement Project Compliance Measures

The Effect of Surgical Care Improvement Project Compliance on Surgical Site Infections
February 2015
Cataife, G., Weinberg, D. A., Wong, H. H. & Kahn, K. L.
Medical Care
IMPAQ Health
Cataife, G., Weinberg, D. A., Wong, H. H. & Kahn, K. L. (2014) The effect of Surgical Care Improvement Project (SCIP) compliance on surgical site infections (SSI). Medical Care, 52(2, Supplement 1), S66-73.

To lower the frequency of surgical site infections (SSIs), the Surgical Care Improvement Project (SCIP) developed a set of process compliance measures. However, research has yet to confirm whether compliance with these measures results in lower SSI rates. Guido Cataife and Daniel Weinberg collaborated on research to determine whether complying with SCIP measures resulted in lower SSI incidence rates in a hospital setting. They also sought to learn which specific measures were most influential in the relationship between SSI rates and SCIP measure compliance.

Researchers studied 295 hospital groups annually from 2007-2010 and linked these groups' SCIP compliance rates with SSIs. Each hospital group consisted of all hospitals that shared identical categories for location by state, teaching status, bed size, and urban/rural location. To estimate associations between 3 specified SCIP measures and SSI rates, researchers created a generalized linear model regression, including a logistic link and binomial family.

The results of this study showed that for the SCIP measures "antibiotic timing" and "appropriate antibiotic selection," hospital groups with higher compliance rates experienced significantly lower SSI rates. More specifically, median-characterized hospital groups experienced a 5.3 percent decrease in SSI rates when their measurement of the provision of antibiotics 1 hour before an intervention improved by 10%. This association between SCIP measure compliance and SSI rates was particularly apparent for rural hospitals, who experienced much larger effects than urban hospitals. The third specified SCIP measure, Timely Antibiotic Stop, was not associated with SSIs. The results of this analysis lend support to the validity of the two healthcare-associated infection metrics that are available to the public.