Reducing Surgical Site Infection in Colorectal Surgery V2
Care Continuum
Technology
National University Health System Quality Improvement
National University Health System
25 March 2026
20% reduction in surgical site infections (SSI) in Colorectal Surgery from 10.9% to 8.72% within 1 year from the start of. Regular project meetings were important when reviewing care bundle compliance data and enabled continuous monitoring and shared.
Year Submitted: 2025
Published Date: 25 March 2026
Tags: Care Continuum, Acute Care, Trauma Care, Clinical Practice Improvement, Risk Management, Adverse Outcome Reduction, Value Based Care, Safe Care, Technology, Medtech
About this Content
Aims
20% reduction in surgical site infections (SSI) in Colorectal Surgery from 10.9% to 8.72% within 1 year from the start of intervention.
Background
Data from ACS NSQIP audits identified an unacceptable incidence of surgical site infections in General Surgery (bottom 25% compared to similar hospitals internationally) with Colorectal surgery having the highest SSI rate.
Methods
Literature review to identify 10 evidence-based interventions, impact vs implementation priority matrix to prioritize interventions, development of 7-element care bundle, PDSA cycles with progressive implementation, baseline data collection by surgeons, monthly case reviews of non-compliant cases, regular team meetings with project members, visual reminders (redosing charts in drug carts), individual performance reports to senior doctors, and surgeon-level compliance data reporting.
Results
Overall reduction in SSI within Colorectal Surgery by 25.7% from 10.9% (pre-implementation) to 8.1% (post-implementation)
Average compliance of 62% achieved in first PDSA cycle
Improvement in compliance observed after individual performance reporting
Baseline compliance rates varied from 0% to 81% across the 7 care bundle elements
Target of 90% compliance set for all care bundle elements
Lessons Learnt
Regular project meetings were important when reviewing care bundle compliance data and enabled continuous monitoring and shared accountability. Team meetings were useful as a forum for staff to share feedback on bundle implementation challenges and suggest process improvements. Involve surgical leaders and secure buy-in for SSI guideline development and implementation to influence culture change.
Keywords
surgical site infection, colorectal surgery, care bundle, antibiotic prophylaxis, wound protector
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | Ng Teng Fong General Hospital |
Platform(s) | National University Health System Quality Improvement |
Healthcare Professional Group(s) | Healthcare Administration, Medical, Nursing |
Applicable Specialty or Discipline | Medical, Infectious Diseases, Surgery, Nursing, Nursing Research |
Project Lead(s) | Pang Lu Kiat |
Project Member(s) | Seow Choon Sheong |
Connect with this contributor!
Pang Lu Kiat - pang_lu_kiat@nuhs.edu.sg
Project Attachment
Reducing Surgical Site Infection in Colorectal Surgery V2.pdf