Orthopaedic and cardiac
clinical director and surgeon
perception survey 2017 results

Introduction

This report summarisesthe high-level findings from a perception survey relating to the Health Quality & Safety Commission’s Surgical Site Infection Improvement (SSII) programme. The survey was conducted in March 2017.

The aim of the survey was to capture the perceptions of clinical directors of orthopaedic and cardiac surgery, and orthopaedic and cardiac surgeons. Cardiac clinical directors and surgeons weresurveyed for the first time.

Knowing those perceptions will help the national SSII programme team better understand the needs of our stakeholders, and try to better address any issues raised. It is also a useful way of identifying what the programme has done well, so we can continue to maintainhigh standards.

Some of the questions in the survey had different answers to those in the 2014 and 2016 surveys, reflecting changes in the SSII programme over time.

Summary of results

Demographics of respondents

Ten respondents completed the survey (four orthopaedic surgeons, five clinical directors of orthopaedic surgery and one clinical director of cardiac surgery), representing nine district health boards (DHBs). We only received feedback from one respondent for cardiac surgery, which was lower than anticipated. The number of respondents is greatly improved compared to the 2016 survey, where there were six respondents (five orthopaedic surgeons, and one clinical director of orthopaedic surgery) representing five DHBs.

Perceptions of the SSII programme

Ninetypercent of respondents thought the SSII programmewas ‘very important’ or ‘somewhat important’ to improving patient outcomes, compared with86 percent of respondents in the 2016 survey.

The most frequently cited benefit of the SSII programmewas ‘improving patient safety and the patient experience’, followed closely by ‘ensuring consistency and adherence to best practice’.

Most respondents believed interventions introduced as part of the national SSII programmewere ‘business as usual’.

Most respondents have changed their practice as a result of the SSII programme, mainly in their ‘departments’ rather than on an individual basis.

Feedback from respondents included improved administration of antibiotics.

SSII programme reporting

All 10respondents discussed the quarterly national SSII programme reports within their organisation. Most discussedthem with their surgical departments, and clinical head/directors of surgery/chief of surgery. Very few respondents discussed the reports with their chair of the infection control committee, senior leadership team within their DHB and quality manager.

Eightypercent of respondents (n=8) said the individual DHB reports representingindividual surgeon performance data were either ‘very useful’ or ‘useful’.

When respondents were asked what additional information they would like to receive, they replied:‘what we get is good’.

The main aspects of the national SSII reports that respondents found either ‘very helpful’ or ‘helpful’ in ranked order were:

  1. the summary table of SSI cases
  2. introduction/summary of findings
  3. the regional comparisons
  4. the tables
  5. the graphs.

Engagement and support

Respondents ranked their level of engagement with the following from highest to lowest:

  1. their DHB infection prevention and control(IPC) team
  2. local SSII multidisciplinary team
  3. their regional IPC network.

Eightypercent of respondents indicated the resources currently available to support the SSII programmeare appropriate, with 20 percent of respondents ‘unsure’ of whether they are appropriate.

Respondents were asked what other surgical procedures could benefit from being included in the SSII programme. They responded:

  • general surgery
  • general surgery and gynaecology
  • all surgical specialties
  • non-joint replacement orthopaedics.

Conclusions

The overall resultsof the perception survey were mainly positive, suggesting that the SSII programme is seen widely as important for improving patient outcomes.

While the quarterly national SSII programme reports are discussed within DHB surgical departments, and with directors of surgery and suchlike, there are some further opportunities for reports to be discussed with chairs of infection control committees and quality managers.

Individual DHB and surgeon performance reports are being positively received. There were no requests for moreinformation.

The reports should continue to include the summary table of SSI cases, and the introduction/summary of findings. There may be scope to look further at the graphs contained within the reports.

While engagement with IPC teams and local SSII multidisciplinary teamwas high, there are opportunities for better engagement with regional IPC networks.

The national SSII programme team and Strategic Infection Prevention Control Advisor Group discussed the findings of the perception survey. They have identified some key areas to progress, which are listed below in the recommendations.

Recommendations

The national SSI programme team will:

  • discuss with regional IPC networks opportunities to better engage clinical directors
  • maintain the level of information displayed in national SSII programme reports
  • focus more on working with DHBs to engage with infection control committees.

Orthopaedic and cardiac clinical director and surgeon perception survey 2017 results1