The Impact of a Value Based Approach on Practice Methodologies in Colon and Rectal Surgical Patients at William A. Beaumont Hospital, Royal Oak, MI.
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Surgical site infections are the most common form of healthcare associated infection and a substantial cause of morbidity, mortality and prolonged hospital stay in colon and rectal procedures (Center for Disease Control, 2019). The National Health Safety Network, NHSN, enforced new patient care practices through the Accountable Care Act in 2015 penalizing hospitals with higher rates of surgical site infections. William Beaumont Hospital in Royal Oak, MI adapted these new practice methods in 2015 in efforts to prevent surgical site infections as well as adopt more effective ways of recording infections to hold hospitals accountable for postoperative complications in surgical patients. Variables analyzed in order to determine the effect of this change in practice methodologies are wound classification, ASA score based on patient health and recorded PATOS rates all prior to the surgical procedure. A significantly larger number of dirty-infected cases reported in 2018 was found than dirty-infected cases reported in 2016, after the enforcement of the Accountable Care Act. More surgical site infections were reported in 2018 than in previous years. These results are due to changes in pre-surgical assessment and practice methodologies enforced by the Accountable Care Act.