Other Surgery Measures



Antibiotics Discontinued 24 Hours after Surgery

What are we measuring and why?

MGH tracks the percentage of eligible adult surgery patients whose prophylactic antibiotics are discontinued within 24 hours of the surgery end time (48 hours for cardiac surgery).  Unless there is a specific reason (for example, fever or other signs of infection), there is no benefit to administering antibiotic for more than 24 hours after the end of surgery.  Unnecessary use of antibiotics also can contribute to the spread of drug-resistant infections that are difficult to treat.

How are we doing and how do we compare to best practice?

Since the beginning of 2007, over 90% of eligible surgery patients have had their antibiotics discontinued within the appropriate timeframe. This data is no longer being collected by the Joint Commission (TJC), nor is it being publically reported. Our performance for the last reporting period, January 2014 to December 2014 was 96%. The national average for all Joint Commission accredited hospitals was 98%.

Click to see MGH’s performance on this measure by patients’ race.

  • Current Scores
  • Scores Over Time
  • Higher values are better
98% 100% 96%

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.

N.B. Data for this measure is no longer being collected, nor is it publically reported.

MGH: Jan 14-Dec 14
TJC: Jan 14-Dec 14

97 97 98 98 96 96 96 96 98 98 98 98 98 98 98 98 100 100 100 100 100 100 100 100

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.

N.B. Data for this measure is no longer being collected, nor is it publically reported.



What are we doing to improve?

In the past two years, MGH has standardized antibiotic order regimens so that antibiotics are discontinued at the appropriate time. Post-operative orders within the computerized systems have been standardized and updated to assist with timely discontinuation of antibiotics. Post-operative order sets of those services covered by this initiative have been updated with prophylactic antibiotic orders that limit the number of doses given to only two post-operatively. Doctors may order additional antibiotics in special circumstances, such as if there are signs of a possible post-surgical infection. We reviewed all those patients’ cases in which the antibiotics were extended beyond the recommended time.  In some cases, this extension was very brief and in other cases the extension was ordered when the physician felt it was necessary. We are reviewing the guidelines with all of our surgical services. We expect to see steady improvement in this area, given our recent performance improvement work.

What can you do to ensure that your antibiotics are discontinued at the appropriate time?

Post-surgical patients and or family members can play an important role in making sure that they have their antibiotics discontinued as appropriate. Family members should ask about the discontinuation of antibiotics, and what the hospital does to avoid unnecessary use of antibiotics.

 

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