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New Study Reveals Need for Change in Surgical Procedures

Easton, Maryland, February 22, 2005-Delmarva Foundation announced today that acute care hospitals are making progress in their efforts to prevent surgical infections among Maryland residents.

As Delmarva works with local hospitals to improve delivery and administration of preventative antibiotics, it is reporting widespread successes across the state for hospitals that participated in Surgical Infection Prevention Collaborative during 2003 and 2004 as well as planning for an expanded focus on surgical infection prevention in the near future.

Participating hospitals in the state began work on the collaborative in 2002 as part of a surgical infection prevention project jointly sponsored by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). Methodologies to achieve improvement included staff education, increased awareness of procedures, and standardization of administrative processes.

Some notable local success stories in Maryland include those of North Arundel Hospital in Anne Arundel County, Montgomery County's Holy Cross Hospital, and Peninsula Regional Medical Center, located in Salisbury.

Delmarva's announcement is in conjunction with a study published by the Archives of Surgery highlighting the need for better, more consistent practices to address infection risk factors. Delmarva plans to intensify its work with local hospitals to redesign procedures and protocols so that surgical patients are given antibiotics within sixty minutes before surgery begins, the timeframe most effective for preventing infections.

The precise timing of administering antibiotics to prevent surgical infections is critical, but often not strictly regulated. In the Archives of Surgery study, titled "Use of Antimicrobial Prophylaxis for Major Surgery: Baseline Results From the National Surgical Infection Prevention Project," researchers found that only a little more than half of Medicare beneficiaries undergoing major surgery received antibiotics in the optimal timeframe.

In the article, researchers report the results of their analysis of medical records from 2965 acute care hospitals throughout the United States, involving a random sample of 34,133 Medicare inpatients undergoing major surgeries during 2001- including open cardiac, vascular, colorectal, total hip, total knee, and hysterectomy. Data was collected in conjunction with the 2002 launch of the CMS/CDC surgical infection prevention project.

"Delmarva recognizes the importance of this research and, seeing the opportunity for significant improvement, already has efforts underway to address the problem of surgical infection prevention," said Maulik Joshi, President and CEO of Delmarva Foundation.

Highlights in Maryland hospitals include:

• North Arundel Hospital in Anne Arundel County was able to triple the number of surgical cases performed between the occurrences of surgical site infections. The rate of infection went from nearly 3 percent (2.8) in the first quarter 2002 down to less than 1 percent (0.8) in the fourth quarter 2003.
• Antibiotics at North Arundel were administered within the recommended time 89 percent of the time, up from 78 percent at the start of the collaborative.
• Holy Cross Hospital in Silver Spring also achieved significant improvement in their rates, moving from 38 percent of patients receiving antibiotics within one hour prior to surgery at the start of the program up to 90 percent at the most recent measurement.
• The percentage of patients receiving the recommended antibiotics also increased from 73 percent to 97 percent.
• Finally, Holy Cross showed an increase in the rate of patients having antibiotics discontinued within the recommended 24 hours of surgery, with rates improving from 75 percent to 97 percent.
• Salisbury's Peninsula Regional Medical Center reduced their surgical infection rates by 33 percent. The percentage of patients receiving antibiotics within one hour prior to surgery improved from 37 percent at the beginning of the collaborative to 87 percent at the most recent remeasurement.
• Peninsula also increased the number of patients receiving the appropriate antibiotics from 92 percent to 98 percent.

As part of Medicare's Hospital Quality Initiative, Quality Improvement Organizations (QIOs) like Delmarva promote rapid resolution of hospital quality issues and sharing of "best practices" to assist hospitals in improving their quality of care in several areas. In addition to surgical infection prevention, focus areas include heart attack, heart failure and pneumonia.

For more information, please see www.delmarvafoundation.org.

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About Delmarva Foundation
Delmarva Foundation is a national, not-for-profit organization dedicated to improving healthcare quality in over 20 states. Since 1973, Delmarva has assisted in improving care in hospitals, nursing homes, home health agencies, medical practices and health plans. Delmarva performs quality improvement, quality assurance, utilization review, external quality review and Program Safeguard activities. The company's corporate headquarters are located in Easton, Maryland with other offices in Baltimore, Maryland; Washington, DC; Columbia, South Carolina; Tampa, Florida; and Tallahassee, Florida. For more information, please visit Delmarva Foundation on the web at www.delmarvafoundation.org.