Surgical care improvement project in the value-based purchasing era: More harm than good?

Trish M. Perl, Adam Weston, Kathleen Caldera, Shira Doron

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


The Surgical Care Improvement Project (SCIP) started in 2006 as a core measure to reduce perioperative morbidity and mortality, with many measures addressing perioperative antibiotic usage and timing. However, measures are often rolled out without consideration of their full impact, causing confusion, frustration, and possibly patient harm. We have provided examples of each. The institution of SCIP has markedly increased the compliance to its measures but little evidence shows that it provides any substantial benefit to patients, whereas this improved compliance comes at the cost of significant time, money, and staff resources. Despite this, several SCIP measures, which are currently incorporated into quality contracts, will be tied to Medicare reimbursement in 2013 under value-based purchasing, with third-party payers likely following suit. This may lead to inappropriate lower compensation of hospitals providing good care with questionable effects on patient outcomes.

Original languageEnglish (US)
Pages (from-to)424-427
Number of pages4
JournalClinical Infectious Diseases
Issue number3
StatePublished - Feb 2013
Externally publishedYes


  • SCIP
  • Surgical Care Improvement Project
  • antibiotics
  • prophylaxis
  • surgical site infection

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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