Project JOINTS Exemplar Hospital Application
Willamette Valley Medical Center – McMinnville, Oregon
Number of licensed beds: 88
Non- Teaching
Rural
Exemplar Hospital Contact Name: Natalie Reed, Joint Care Coordinator, PT
Email: Natalie.Reed@capellahealth.com
Phone: 503-435-6571
[ X ] We give permission to IHI to make public all the information on this Project JOINTS Exemplar Hospital application.
Enhanced Surgical Site Infections Prevention Bundle element: Use of an alcohol-containing antiseptic agent for
preoperative skin preparation
In a few sentences, describe in what ways your hospital has been successful in implementing this element of the
Enhanced Surgical Bundle. Please answer the following questions:

What key changes did your organization make to incorporate or support use of an alcohol-containing antiseptic
agent for preoperative skin preparation? What were the changes in existing processes your organization had to
make in order for this to become part of the routine?
 Current alcohol-containing antiseptic agent has been in use for 4-5 years.
 Prior to this change, we had noted an increase in allergic skin reactions and some of the
surgeons wanted to change products. We were also dissatisfied with the labeling on our prior
agent in regards to fire safety. These issues made it relatively easy to change to our current
alcohol-containing antiseptic agent.
 We educated surgeons that the likelihood of allergic reactions was less with the new product.

How did you roll out this practice? Did you test it with one patient, a few, or all to start?
 Initially we trialed the product on a few surgical patients to make sure it worked well and then
were able to quickly roll it out to all surgical patients. We have had no concerns since then with
its use.

What lessons have you learned as you've implemented this practice? What tips do you have to share?
 It is helpful to trial a new product with a few patients first to make sure staff know how to use it
properly and have key surgeons become familiar with its use.
 This also led to further education for staff regarding other issues in the OR such as fire safety
and a mock fire drill with the local fire department.
 It is helpful to officially track this data to ensure compliance.
Measurement
Measurement provides information on whether the changes made to implement the Enhanced Surgical Bundle are
resulting in improvement. In any improvement initiative, the ultimate goal is to improve an outcome measure (e.g.,
reduce SSIs); hospitals and surgical practices will accomplish this by first improving the processes that are key drivers.
Please provide for us any information you can regarding compliance with process measures, in this case:

We started formally tracking this data for our elective total hip and total knee patients on April 1, 2012.
Q2 data
54/54= 100% compliance with this patient population
Numerator Definition: Number of patients undergoing hip or knee replacement surgery with skin antisepsis at the
surgical site using an alcohol-containing preoperative skin antisepsis agent (e.g., chlorhexidine gluconate plus alcohol or
iodophor plus alcohol)
Denominator Definition: Number of patients undergoing elective hip or knee replacement surgery