ADJUNCTIVE USE OF MONTHLY PHYSICIAN QUESTIONNAIRES FOR SURVEILLANCE OF SURGICAL SITE INFECTIONS AFTER HOSPITAL DISCHARGE AND IN AMBULATORY SURGICAL PATIENTS - REPORT OF A 7-YEAR EXPERIENCE

We report experience with the use of monthly physician questionnaires, in conjunction with traditional in-house monitoring, for surveillance of surgical site infections (SSIs) in inpatients after hospital disch arge and in ambulatory surgical patients (i.e., those not requiring pe rioperative hospitalization) over a 7-year period (July 1988 to June 1 995) involving 156,977 surgical procedures; The mean annual response r ate was 73% and did not change significantly from year-to year (range, 71% to 75%), but the proportion of surgical procedures covered by ret urned surveys increased during the study period from 75% to 81% in inp atients and from 78% to 86% in ambulatory surgical patients (p < 0.000 1 for both comparisons), Of 1051 SSIs identified, 231 (22%) were ident ified solely by the survey: 16% of SSIs in inpatients after discharge and 66% of SSIs in ambulatory surgical patients, Of 787 cases meeting the criteria for SSI on the basis of in-house surveillance and listed on returned questionnaires, 366 (47%) were not marked as SSIs by the r esponding surgeons. We conclude that since its implementation in 1988, monthly physician surveys at our medical center continue to contribut e significantly to identification of otherwise undetected SSIs. Howeve r; monthly questionnaires should only complement, not replace, traditi onal in-house surveillance.