How to Use This Toolkit

The GOAL for hospitals participating in the 2025 ISQIC SSI project is to consistently follow 13 care processes for patients having colorectal resection surgery. The 13 processes are summarized in this graphic:

The data your SCR is collecting will allow you to see what your current performance is for each of the care processes above. These 13 care processes are the "bundle" we are asking you to implement, and performance (consistency of use of each process) is what the data collection will allow us and you to measure. We may refer to these 13 bundle elements as "measures".

Your hospital may already consistently follow some of these bundle elements, while some may be new to your hospital, or may only be done by some providers.

This toolkit is here to help your SSI Project team implement or standardize the 13 bundle elements above. You will likely only need to use some of these resources, depending on your hospital’s current performance.

How do I get started?

1. Assemble your SSI Project Team

   • Refer to the toolkit section below called "Build your Team and Process Mapping" for resources for "pitching" this project and who should be on your SSI team.

2. Determine how care is currently happening for colectomy patients - to understand what needs to change for each of the 13 bundle elements to be consistently done.

   • Refer to the toolkit section below called "Build your Team and Process Mapping"

3. Review your hospital’s current performance for each of the 13 bundle elements.

   • If your hospital is not consistently using one or more of the 13 bundle elements, go to the toolkit for that phase of care (preoperative, perioperative, operative, postoperative), and use the toolkit resources in that section. They are examples intended to be modified by you for your hospital.

     • For example, if your colectomy patients are not consistently taking a mechanical bowel prep with oral antibiotics, you might

       • Discuss the situation with your surgeon champion and her office staff

       • Determine how the bowel prep instruction are currently being given, and why patients might not be receiving or following the instructions

       • Offer the example instructions for bowel prep in the toolkit, which could be modified and used

       • Work with the surgeon champion to reach out to all of your hospital's surgeons with the recommendation to use mechanical prep with oral antibiotics

     • Another Example: if your surgeons aren’t using a "clean closure" instrument tray for colectomy cases, you might

       • Discuss the situation with your surgeon champion and your team member from the OR team

       • Determine why a clean closure isn’t being used, from the perspective of the stakeholders (surgeons, scrub techs, circulating nurses)

         • Offer the sample "pick list" in the toolkit to make it easier for the OR to create

       • Perhaps a clean closure tray is being used, but it's not documented anywhere

         • Offer your surgeons the "dot phrase" for documenting SSI bundle practices in their operative notes

We hope this toolkit is useful for your hospital, and together we can reduce infections for our colectomy patients across the collaborative!