Report finds low infection rate for hip replacement or revision procedures at HSS

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For the fourth year in a row, Hospital for Special Surgery has an infection rate that is significantly lower than the New York State average for hip replacement or revision surgeries, according to the 2011 report on hospital infection rates just released by the State Department of Health.

"It is vital to a patient's well-being that they are aware of a center's infection rate when choosing where to have surgery," said Louis A. Shapiro, president and CEO. "As a national leader in orthopedics, our entire staff is committed to quality and to providing an environment for excellence in patient care and safety."

Surgeons at Hospital for Special Surgery performed the most hip replacement surgeries in New York State, with nearly 4,200 procedures, which is about 15 percent of the approximate 27,000 hip replacement or revision procedures in New York State in 2011. Among the 167 hospitals included in the report, Hospital for Special Surgery had a statistically lower surgical site infection rate of 0.4 percent compared with the state average of 1.12 percent for total hip replacement or revision hip procedures.

"At Hospital for Special Surgery, we perform almost four times more total hip replacement surgeries than any other institution in New York State, and the most in the country," said Surgeon-in-Chief Dr. Thomas P. Sculco. "We are totally committed to employing the most advanced techniques to prevent this devastating complication."

Hospital for Special Surgery's specialization in orthopedic surgery allows for systems that improve efficiency in surgical settings within each operating room, lowering surgical times and improving safety. Numerous best practices—many pioneered at Hospital for Special Surgery—have helped to keep infection rates low. The Hospital's anesthesiologists are leaders in using regional anesthesia for joint replacement, which limits anesthesia only to the surgical region, and reduces bleeding and surgical time.

"An infection prevention nurse is dedicated and oversees the operating room, and each room is standardized, improving efficiency and lowering surgical time by having surgical tools laid out and organized in the same order," explained Eileen Finerty, RN, nursing director for Infection Control and Occupational Health.

All joint replacement procedures are performed skillfully and quickly, in an average of one to two hours. "In general, the shorter the surgical time, the lower the risk for infection," said Dr. Sculco.

During surgery, a patient's exposure to contaminants is minimized, because they are isolated from the environment by a specially designed Plexiglas enclosure, which helps to improve air flow and to restrict excess personnel at the surgical field. After surgery, the operating rooms are meticulously cleaned by staff that is regularly monitored for competency by the infection control nurse, and the infection control department ensures that heightened standards are maintained.

An electronic data monitoring program serves as a "first alert" system for new cultures and organisms that could pose a threat to patient safety.

New York State's strict regulatory and surveillance systems require hospitals to report certain hospital-acquired infections to the State Department of Health. This year's publication is the fifth annual report of hospital-acquired infections in New York State, but the fourth annual report to include hip replacement procedures. The report states that the data are made publically available each year to give people information about hospital performance that could help them make informed medical decisions.

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