Impact of implementation of the Surgical Care Improvement Project and future strategies for improving quality in surgery

BackgroundWe present a comprehensive systematic review of the effect of Surgical Care Improvement Project (SCIP) measures on surgical site infections (SSIs) as related to SCIP compliance.Data SourcesA systematic review of the peer-reviewed literature was performed on PubMed, Medline, and Cochrane database group using their own search engines. Keywords used were Surgical Care Improvement Project (SCIP), adherence, compliance, surgical site infection (SSI), infection bundle, antibiotics, perioperative antibiotics, and combinations thereof. Furthermore, reference lists of selected articles were cross-searched for additional literature. Papers published from January 1, 1998 to January 1, 2014 were included.ResultsA comprehensive analysis of these data demonstrated an 18% decrease in the odds of developing SSI and a cumulative 4% decrease in SSI. The largest increases in compliance for individual SCIP measures were reported between 2004 and 2006. However, compliance with multiple measures simultaneously had the sharpest increase between 2006 and 2009 without a definitive asymptote ascertained from the current data.ConclusionsThese results represent some positive progress toward the SCIP task force's 2006 goal of a 25% decrease in SSI by 2010. Suggestions for improved future papers in this area were also added.