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Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.

Publication ,  Journal Article
Baker, AW; Haridy, S; Salem, J; Ilieş, I; Ergai, AO; Samareh, A; Andrianas, N; Benneyan, JC; Sexton, DJ; Anderson, DJ
Published in: BMJ Qual Saf
August 2018

BACKGROUND: Traditional strategies for surveillance of surgical site infections (SSI) have multiple limitations, including delayed and incomplete outbreak detection. Statistical process control (SPC) methods address these deficiencies by combining longitudinal analysis with graphical presentation of data. METHODS: We performed a pilot study within a large network of community hospitals to evaluate performance of SPC methods for detecting SSI outbreaks. We applied conventional Shewhart and exponentially weighted moving average (EWMA) SPC charts to 10 previously investigated SSI outbreaks that occurred from 2003 to 2013. We compared the results of SPC surveillance to the results of traditional SSI surveillance methods. Then, we analysed the performance of modified SPC charts constructed with different outbreak detection rules, EWMA smoothing factors and baseline SSI rate calculations. RESULTS: Conventional Shewhart and EWMA SPC charts both detected 8 of the 10 SSI outbreaks analysed, in each case prior to the date of traditional detection. Among detected outbreaks, conventional Shewhart chart detection occurred a median of 12 months prior to outbreak onset and 22 months prior to traditional detection. Conventional EWMA chart detection occurred a median of 7months prior to outbreak onset and 14 months prior to traditional detection. Modified Shewhart and EWMA charts additionally detected several outbreaks earlier than conventional SPC charts. Shewhart and SPC charts had low false-positive rates when used to analyse separate control hospital SSI data. CONCLUSIONS: Our findings illustrate the potential usefulness and feasibility of real-time SPC surveillance of SSI to rapidly identify outbreaks and improve patient safety. Further study is needed to optimise SPC chart selection and calculation, statistical outbreak detection rules and the process for reacting to signals of potential outbreaks.

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Published In

BMJ Qual Saf

DOI

EISSN

2044-5423

Publication Date

August 2018

Volume

27

Issue

8

Start / End Page

600 / 610

Location

England

Related Subject Headings

  • Surgical Wound Infection
  • Southeastern United States
  • Retrospective Studies
  • Public Health Surveillance
  • Pilot Projects
  • Infection Control
  • Humans
  • Hospitals, Community
  • Health Policy & Services
  • Epidemiological Monitoring
 

Citation

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Chicago
ICMJE
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Baker, A. W., Haridy, S., Salem, J., Ilieş, I., Ergai, A. O., Samareh, A., … Anderson, D. J. (2018). Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study. BMJ Qual Saf, 27(8), 600–610. https://doi.org/10.1136/bmjqs-2017-006474
Baker, Arthur W., Salah Haridy, Joseph Salem, Iulian Ilieş, Awatef O. Ergai, Aven Samareh, Nicholas Andrianas, James C. Benneyan, Daniel J. Sexton, and Deverick J. Anderson. “Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.BMJ Qual Saf 27, no. 8 (August 2018): 600–610. https://doi.org/10.1136/bmjqs-2017-006474.
Baker AW, Haridy S, Salem J, Ilieş I, Ergai AO, Samareh A, et al. Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study. BMJ Qual Saf. 2018 Aug;27(8):600–10.
Baker, Arthur W., et al. “Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.BMJ Qual Saf, vol. 27, no. 8, Aug. 2018, pp. 600–10. Pubmed, doi:10.1136/bmjqs-2017-006474.
Baker AW, Haridy S, Salem J, Ilieş I, Ergai AO, Samareh A, Andrianas N, Benneyan JC, Sexton DJ, Anderson DJ. Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study. BMJ Qual Saf. 2018 Aug;27(8):600–610.

Published In

BMJ Qual Saf

DOI

EISSN

2044-5423

Publication Date

August 2018

Volume

27

Issue

8

Start / End Page

600 / 610

Location

England

Related Subject Headings

  • Surgical Wound Infection
  • Southeastern United States
  • Retrospective Studies
  • Public Health Surveillance
  • Pilot Projects
  • Infection Control
  • Humans
  • Hospitals, Community
  • Health Policy & Services
  • Epidemiological Monitoring