Automated Surveillance System to Monitor Surgical Site Infections for the Patient Safety Campaign in Wales

Background: The ‘1000 Lives Campaign’ was launched in Wales in April 2008. It aims to improve patient safety and increase healthcare quality across Wales via the implementation of a number of life-saving interventions to reduce avoidable risks and harm. There is a particular requirement in the campaign to reduce surgical site infections. To assist hospitals in monitoring their success in this goal and provide a consistent outcome measure, a surveillance tool was required allowing a multidisciplinary team approach to collecting and analysing data on infections following multiple surgical procedures.
Objective: The objectives were to develop and implement a surveillance system to collect, validate and analyse data on infections following any elective surgery in Wales, to provide outcome measures for the surgical content area  of the ‘1000 Lives Campaign’. The system needed to incorporate multi-user data entry of a small dataset, allowing simple analysis by means of pre-defined reports and an export option to for complex analysis locally.
Methods: Data is captured via a web based Groupware product. Authorised personnel (including primary care staff, if required) are issued with a user name and password.  Core data items are entered online at the time of the surgical procedure. For validation purposes drop down selection lists are provided to reduce occurrence of transposing errors during data entry. If an infection occurs, the patient record can be updated with infection data, otherwise the patient is assumed to have no infection. Infection details can be entered during the inpatient stay or post-discharge. Hospitals are able to view their own data via a secure web-based reporting system developed using SQL server 2005 and vb.net 2005 interface.  A valid user id and password is required. Pre-defined reports were developed and a data export facility included in the system.

Results: The system was successfully implemented in October 2008, 6 months after the start of the campaign. It has been used to collect surveillance data on infections following various types of surgical procedures, such as breast and vascular. It provides a simple means of collecting data avoiding the use of paper forms.  Data entry by multiple types of hospital personnel is permitted and post-discharge infection reporting by primary care staff is possible. The system includes 8 predefined reports providing simple surgical site infection rates that can be monitored over time and fed back as outcome measures to the ‘1000 Lives Campaign’. The export facility allows for more complex analysis in a third party product.
Conclusions: This system provides a simple, secure and convenient method of data collection and analysis of infections following all elective surgical procedures in Wales. It assists hospitals in providing outcome data to monitor their success in the surgical intervention content area of the ‘1000 Lives Campaign’.