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Research >> Surgical Site Infection

Surgical Site Infection Reduction


Surgical site infections (SSIs) are one of the most common and costly healthcare-associated adverse events in the United States. Over 150,000 patients acquire an SSI each year, costing the healthcare system an estimated $3 billion. In collaboration with national infectious disease experts at Duke University Medical Center, this RO1 grant from the Agency for Healthcare Research and Quality seeks to optimize and test statistical process control (SPC) methods to detect SSI outbreaks significantly earlier to reduce associated mortality, morbidity, and costs. HSyE is leading the SPC optimization process and is further expanding knowledge and methods on the use of SPC in healthcare contexts.

Partners & Research Team

From Duke University Medical Center and Duke Center for Antimicrobial Stewardship and Infection Prevention:


From the Healthcare Systems Engineering Institute:

  • Postdoctoral Fellow: Iulian Ilies, PhD

  • Graduate Students: Joseph Salem, Tiago Jabur

  • Undergraduate Students: Nathan Holler, Nicole Nehls, Adam Schleis

  • Project Manager: Margo Jacobsen


A randomized controlled trial is underway to measure the effectiveness of surveillance using optimized SPC methods and feedback on rates of surgical site infection compared to traditional surveillance and feedback. The trial, Early Recognition and Response to Increases in Surgical Site Infections Using Optimized Statistical Process Control Charts: The Early 2RIS Study, is a prospective, multicenter cluster randomized trial that uses a stepped wedge design. The study will be performed in 29 DICON hospitals over three years, from March 2017 through February 2020. Clusters randomized to intervention will receive feedback on increasing rates of SSI identified through optimized SPC methods. Further details on the clinical trial can be found on


Infectious Disease Week 2017 Conference Poster on SPC Optimization Methods

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