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Invited Critique
March 2011March 21, 2011

Too Much of a Good Thing? Multi-tasking and Distraction in Quality Improvement: Comment on: “Evaluating an Evidence-Based Bundle for Preventing Surgical Site Infection”

Author Affiliations

Author Affiliations: Department of Surgery, University of Michigan, Ann Arbor.

Arch Surg. 2011;146(3):270. doi:10.1001/archsurg.2011.7

Health care leaders increasingly focus on improving the quality of surgical care through implementation of bundles, or checklists that encourage compliance with evidence-based processes of care. In a timely and important study, Anthony and colleagues provide high level evidence of the potential dangers of this type of approach. The authors conduct a single-center randomized clinical trial to reduce SSI after colorectal surgery by mandating adherence to 5 practices that have previously been shown individually to be effective in this regard. Contrary to expectations, patients in the intervention arm developed significantly more wound infections.