Surgery
opportunities to compare with their previous submissions, so that they can, as far as possible, evaluate trends. The SSISS (surveillance protocol and service)
ensures that training is available to use the protocol and follow the methodology. Each hospital has access to the web-based data capture system, as well as help with interpreting data and further analyses. The individual hospital reports are generated via the web and are available to interested parties at the hospital level. The service recommends that each Trust forms a surveillance group to plan how the local service will run. It also can interpret and distribute the results to clinical staff and others who need to know, as well as when policy and practice review needs to take place to make amendments.2 They suggest that membership of this group comprises: l The Director of Infection prevention and control (DIPC)
l Surgeons l Anaesthetists l Infection Control Team l Surveillance staff l Ward and Theatre staff l Clinical governance l The Trust Board
The data on the surveillance sheet is comprehensive requiring a great deal of information. It serves well to understand what is needed for submission before the on-line data is put onto the UKSHA site, as it is difficult to return to fill in one section for a number of patients.
GIRFT
Getting It Right First Time (GIRFT), an organisation established by Professor Tim Briggs, ran a programme in hospitals in 2017 to ensure that clinicians (especially surgeons) could look at their own infection control data and find out what was needed, in order to improve their outcomes.
It started as a review of outcomes for elective orthopaedics. The GIRFT organisation returned to collect more Surgical Site Infection data in 2019 to review their progress. This data is not comparable with SSISS, as the definitions are different. There are many specialties covered. It gives some good examples of where quality improvement has taken place, as a result of the feedback from the surveys, and also includes some of the limitations of the survey. Comparisons with 2017 data have not been easy, as data collection used different types of categories.3
Do’s and Don’ts Joanne gave delegates a good number of hints as to how to make the job of data collection for surveillance as easy as possible, so that it was meaningful and comprehensive. She highlighted that it should be in line with GDPR, and patient data needs to be treated with care and respect. She also advised that the whole team needs to be in the communication circle, so that if changes to practice need to be made, at a later date, all team members are aware. Further to this good advice, she stated that it was important that there was not only one
individual collecting and submitting the data – but that more members of the team were involved, to cover holiday times and to share the workload. Further to this, it could be a team decision on which data should be collected. For example, BMI might be collected for some surgeries and not others but, as an important factor in SSIs, the team might want it collected at the start, rather than starting half-way through. She also suggested that after each cycle of data collection, the team reviews what has been submitted. If there is an increase in the number of SSIs for some reason, all the team need to be aware and can expect this feedback. Practice change, if required, can be planned at this stage.
As for Don’ts, Joanne pleaded with the audience not to start on paper, but to get to grips with the online data forms. She said it might take longer, but the advantages of having the data all in one place were significant. There was also sage advice against starting too big – even if this means starting with just one specialty. It’s always helpful to review where others have started and any tricks that they use to make it easier. In addition, it’s always easier
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