The Surgical Care The Surgical Care Improvement Improvement Project (SCIP)Project (SCIP)

Teri Ransbury, Admin. Director Quality & Risk Management / Infection Prevention / Medical Staff

Corona Regional Medical Center

Began in 1933, with the founding of Corona Began in 1933, with the founding of Corona community hospitalcommunity hospital

Merge in 1992 with circle City Medical CenterMerge in 1992 with circle City Medical Center Became Corona Regional Medical CenterBecame Corona Regional Medical Center 240 – bed community hospital240 – bed community hospital -160 – bed acute care hospital-160 – bed acute care hospital - 80-bed rehabilitation campus- 80-bed rehabilitation campus Employs more than 1,000 trained health care Employs more than 1,000 trained health care

professionalsprofessionals

Corona Regional Medical Center

300 physicians representing more than 40 specialties

71% of our professionals, clinical and ancillary staff live in the greater Corona/Norco area

We seek to be the leading community healthcare provider, serving our communities as the healthcare partner of choice for patients, staff, and physicians.

Corona Regional Medical Center2008 v 2009

0

20

40

60

80

100

120

Abx w/in

1 hr of in

cision-O

verall

Abx Selection-O

verall

Abx D/C'd w

/in 24 hrs-

Overa

ll

Appro H

air Remova

l

Colorectal Im

med Post-op N

o...

B/B prio

r to admiss

ion & peri-

op

VTE Prophyla

xis

VTE Prophyla

xis Tim

ing

2008

2009

STAFF EDUCATION Monthly nursing staff meetings Medical staff meetings Nursing orientation SCIP/Core measure packets and tests for

nursing registry Posters

STRATEGIES

SCIP/ CORE MEASURE TEAM Biweekly Meetings Members:

Chief Nursing Officer Nursing Directors-ED, ICU, MS,PCU Nursing Educator Nursing Managers Pharmacy Director Quality Director/Manager

SCIP Coordinator Core Measure Coordinator Core Measure Nurse

STRATEGIES

INCLUDES: Discontinuation of prophylactic antibiotics

within 24 hours (the pharmacy places STOP date and time)

Correct selection of prophylactic antibiotics VTE Prophylaxis orders

Develop Pre-Printed Orders

Green Sticker Documents reasons

for not discontinuing prophylactic antibiotics

DEVELOP STICKERS TO ALERT NURSES AND PHYSICIANS

SCIP LABEL

Post-op charts are identified. The sticker is placed in front of the chart.

DEVELOP STICKERS TO ALERT NURSES AND PHYSICIANS

Foley Necessity Sticker

• Letters to the Nurses and Physicians• Nursing champions for each unit• Communicate with Physicians

• Correct selection of prophylactic antibiotics

• Copies of preoperative pre-printed orders

STRATEGIES

Develop SCIP/Core Measure Bulletin Boards Posted monthly with colored graphs Posted in each unit

Recognize SCIP Stars Names of physician in each star who are SCIP

champions

Anesthesiologist are responsible for administering and documenting pre-op antibiotics in O. R.

STRATEGIES

Preoperative pre-printed orders Core Measure Checklist Prophylactic Antibiotic orders VTE Prophylactic orders Total Joint orders Hysterectomy orders

SCIP FORMS

Adult Surgical Antibiotic Prophylaxis Orders

Appropriate Antibiotic according to Procedure

Within 30-60 minutes of incision

Discontinuation within 24 hours of surgery

Adult Venous Thromboembolism Prophylaxis Orders

Post-Op Total Joint Orders

Includes Appropriate Antibiotic

Discontinuation within 24 hours

VTE Prophylaxis

And

the journey

continues……

SCIP

QUESTIONS ???

THANK YOU