A good example of how an
arbitrary standard could limit quality improvement
is the report on surgical wound infections by Classen
et al.3 The primary deep surgical wound infection
rate at the large teaching hospital cited in the report
was 1.8%. A typical QA review would very likely
have concluded that nothing needed to be done,
because this was well within acceptable wound infec-tion rates. Nevertheless, a quality improvement pro-ject improved the process of prophylactic antibiotic
administration, leading to a reduced wound infec-tion rate of 0.4%. This improvement in care was
associated with an annual cost savings of more than
$700,000.