National roll-out: Surgical Site Infection Surveillance Programme

29 May 2013 | Infection Prevention & Control

A sophisticated patient safety initiative that will reduce harm caused to patients by surgical site infections has been established for the first time in the New Zealand health sector.

The Surgical Site Infection (SSI) Surveillance Programme, which is one component of the Health Quality & Safety Commission’s (the Commission) infection prevention and control programme and its patient safety campaign Open for better care, has been established to implement an improvement programme that will standardise the collection and reporting of SSIs.

Importantly, it will also encourage culture change and make practice improvements to better support the prevention of SSIs. Combined, these components will ensure that a cycle of continuous quality improvement for reducing SSIs can be achieved in a sustainable way. 

The first step in the three to five year initiative was to implement the surveillance system for hip and knee arthroplasty in eight district health board (DHB) development sites in New Zealand, with a focus on hip and knee surgery. Coronary artery bypass graft and caesarean section surveillance will be incorporated over the next one to two years.

“With the development phase of the SSI Surveillance Programme nearing its successful completion, we are getting ready to roll-out the programme to all remaining DHBs in July,” says Dr Sally Roberts, chair of the SSI surveillance programme steering committee and clinical lead for the infection prevention and control programme at the Commission.

“SSI reduction is a key priority for the New Zealand health and disability sector. Research tells us that up to ten per cent of patients admitted to modern hospitals acquire one or more infections,” she says.

SSIs can have a significant impact on length of stay. International research shows that SSIs can prolong a patient’s hospital stay by 7.4 days, at a cost of $1000 per day (Roy, 2003).

“In 2003, it was estimated that the annual cost of such infections in New Zealand could be in the region of US$140 million,” says Dr Roberts.

“This cost does not factor in the emotional and financial stress upon patients and their families, or that SSIs may result in long term disabilities or even loss of life,” she adds.

With this in mind, participation in the programme will support DHBs to:

  • Improve patient safety and experience
  • Reduce costs associated with surgical site infections – freeing up scarce health sector resources
  • Free up bed days
  • Meet and report against the new Health Quality & Safety Markers agreed by the Minister of Health.

      The SSI Surveillance Programme team will provide DHBs with training on how to implement the programme and on how to use an online SSI surveillance data collection form.

      “Continuous surveillance and regular reporting are necessary to identify changes in infection rates and to effect change,” says Dr Roberts.

      “In time, recommendations on culture and practice change interventions will be made to further increase compliance with best practice for reducing SSIs,” she says.

      The Commission, through Canterbury DHB, is funding the use of an ICNet online data collection form for manual entry of DHB SSI surveillance data until March 2015. Funding includes the development, licencing and support of the software by ICNet and hosting by Canterbury DHB.

      Using the ICNet data collection form will ensure that healthcare professionals have access to standardised and comparable information, allowing them to drive continuous improvements in clinical practice.

      “We recognise that participation in the SSI Surveillance Programme will require an investment of time and resource by DHBs. We firmly believe, however, that participation will result in increased benefits to patient safety,” adds Dr Roberts.

      Promotion of the SSI Surveillance Programme, as part of the Open for better care campaign, will take place from September/October 2013. To find out more visit

Last updated 29/05/2013