Surgical Care Improvement Project (SCIP)- Does it Make a Difference?

The other day I was with my colleagues in infection prevention and cardiothoracic surgery discussing our data on post-operative infections and our adherence to SCIP measures. Of particular interest is our adherence to the choice, timing and discontinuation of antimicrobial prophylaxis for surgery. Compliance with SCIP is publicly reported and affects healthcare reimbursement.


SCIP measures are derived from smaller studies identifying best practices for optimizing surgical outcomes. The question remains, however, does implementation of SCIP measures, wide scale, result in improved outcomes (reductions in surgical site infections)?


The two largest studies to address this critical question were published in the Journal of the American College of Surgeons and the Journal of the American Medical Association.  


The conclusion is a mixed bag. Better adherence to infection-related process measures was not significantly associated with better outcomes in one study. In the second study,  SCIP global adherence was associated with a lower postoperative infection risk. However, adherence reported on individual SCIP measures, which is how SCIP is publicly reported, was not associated with a significantly lower infection risk.


So SCIP adherence may decrease the rate of post-operative infection, but the data is not conclusive. 


At the very least, adherence to SCIP reflects an institution's ability to play within a set of patient care guidelines and to track its own performance.