We have been shortlisted in the ‘Most Impactful Partnership in Preventative Healthcare’ category at the 2024 HSJ Partnership Awards for our work with Cemplicity and healthcare professionals to reduce the impact of surgical site infections (SSI) following caesarean birth.

The PreCiSSIon (Preventing Caesarean Birth Surgical Site Infection across a region) project focussed on work with five maternity units in the West of England using the Cemplicity digital solution, which Health Innovation West of England funded over two years.

Surgical site infection (SSI) accounts for 14.5% of hospital-acquired infections in the UK. The majority present in the community, therefore accurate rates can only be obtained post-discharge. The standard UK measure is patient-reported outcomes (PROM) using the validated Public Health England (PHE) questionnaire at 30 days. This usually involves contacting patients via paper questionnaire or telephone and is very labour intensive.

Caesarean birth is common, yet most hospitals do not know their SSI rates, because case numbers are high and capacity to perform post-discharge surveillance is limited. We aimed to implement SSI surveillance following caesarean birth in the West of England region using the PHE questionnaire delivered by e-PROMS, meaning the questionnaire is delivered by SMS or email at 30 days. As there are approximately 10,000 caesarean births each year, SSI measurement using traditional methods would be unachievable.

This project implemented the Cemplicity digital solution gradually in the maternity units over three months. Cemplicity is used globally by healthcare institutions to capture, measure, and improve Patient Reported Experience (PREMs) and Outcome Measures (PROMs).  The system delivers the PHE questionnaire to patients at exactly 30 days post caesarean birth and is integrated with electronic health records for each hospital.  This required collaborative meetings between clinical, business intelligence and information technology teams in five hospitals, as well as completing the relevant information governance agreements.

By automating the process, the project is reducing the administrative burden associated with paper and telephone surveys and removes human error from data collection. One hospital in the region measures SSI using telephone follow-up by an SSI surveillance team. Project leads used this as a comparator for financial assessment.

To maximise response rates, the project leads also designed a patient information leaflet in partnership with mothers and clinicians, explaining the SSI follow-up process. They also worked with Maternity and Neonatal Voices Partnerships to include ethnicity in the questionnaire’s questions, allowing us to assess whether we are successfully reaching all patient groups. The questionnaire includes free text, enabling us to hear the voices of mothers after discharge and gain valuable insight into our services. The system uses artificial intelligence (AI) technology to identify themes and areas for improvement.

This standardised approach to SSI measurement will now allow the project team to reliably measure SSI rates before and after implementation of an agreed standardised care bundle of four evidence-based interventions. This ambitious quality improvement project, which aims to reduce SSI after caesarean birth, would not be possible without this e-PROMS solution.

The winner of the Most Impactful Partnership in Preventative Healthcare award will be announced at the 2024 HSJ Partnership Awards on 21 March 2024. You can read more about the PreCiSSIon project here.

Posted on February 7, 2024

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