Addressing surgical site infections with robotic-assisted colon surgery

Surgeon uses the da Vinci surgical system in operating room.

Community hospital turns to da Vinci robotic-assisted surgery to help reduce HAC penalties

Legacy Mount Hood Medical Center, a community hospital based in Gresham, Ore., was grappling with ways to lower its colon surgical site infection rate.

The challenges

Legacy Mount Hood’s SSI challenges largely arose from the medical center’s inability to consistently provide minimally invasive surgery (MIS) for general surgery and colon cases. That shortcoming caused the medical center to send many colon cases to hospitals farther away. Not only did the referrals represent a revenue loss, but they also placed a travel burden on the hospital’s lower income and rural patient populations.

A high rate of colon surgical site infections (SSI) triggered financial penalties for Legacy Mount Hood Medical Center, a community hospital, in 2015. Based on a standard 1% annual penalty, the Centers for Medicare & Medicaid Services (CMS) ultimately reduced the medical center’s reimbursements by an estimated total of $585,000.

Each year, 160,000 to 300,000 U.S. patients develop a surgical site infection in the days or weeks following their operations. These complications:1

  • Represent 20% of all hospital-acquired infections
  • Increase hospital length of stay (LOS) by 9.7 days, on average
  • Drive the most readmissions2
  • Place a significant burden on healthcare consumers, providers, and payers, costing the system $3.5 – $10 billion annually

Legacy Mount Hood Medical Center

The solutions

Legacy Mount Hood’s initial solutions achieved only modest success. The hospital implemented several changes, but it wasn’t until the expanded use of da Vinci robotic-assisted surgery (RAS) that SSI rates, and CMS penalties declined while increasing case volume.

Not only have annual colon RAS volumes risen at Legacy Mount Hood, but the hospital’s colon resection standard infection ratio (SIR) is now among the nation’s best.

Graph depicting Legacy Mount Hood’s colon RAS procedure volumes and SSI score.

Legacy Mount Hood’s RAS procedure volumes3 and SSI score.4

The outcomes

Legacy Mount Hood achieved shorter hospitalizations and faster recoveries by transitioning to RAS. The general surgery team felt comfortable providing colon patients the chance to stay closer to home. Legacy Mount Hood was able to upgrade and expand its pool of da Vinci systems, solidify its finances, and free beds for other needs.

From 2017 to 2022, colon RAS at Legacy Mount Hood largely outperformed both open approaches and traditional laparoscopic techniques in clinical measures.

Chart comparing colon RAS at Legacy Mount Hood with open and traditional laparoscopic techniques.

Comparison of colon RAS at Legacy Mount Hood with open and traditional laparoscopic techniques.

Take a deeper dive into the case study

Learn more about how Legacy Mount Hood has used robotic-assisted colon surgery to help lower surgical site infections.

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  1. ScienceDaily. 2017, January 19. Surgical site infections are the most common and costly of hospital infections. ScienceDaily. Retrieved January 13, 2023, from www.sciencedaily.com/releases/2017/01/170119161551.htm.
  2. PSNET.AHRQ.GOV, 2019. [SSIs] are the leading cause of readmissions to the hospital following surgery. Retrieved January 13, 2023, from https://psnet.ahrq.gov/primer/surgical-site-infections.
  3. 2014-2016 procedure volumes from internal ISI system log data. 2017-2021 procedure volumes from Customer’s Custom Hospital Analytics data.
  4. CMS Hospital Acquired Conditions (HAC) SSI domain score from CMS through EOY 2022, with complete score as of 2021. SSI domain score calculated through Standardized Infection Ratio = (Observed/Expected Infections) - 1 year lag in measurement of domain score, 2021 domain score from 2020 data.