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.
Nicholas LH, Dimick JB. 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”. Arch Surg. 2011;146(3):270. doi:10.1001/archsurg.2011.7
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