Leading Change That Matters: Practical Strategies for Perioperative Leaders to Reduce Surgical Site Infections

By David Taylor, MSN, RN, CNOR

This debut column originally appeared in the March-April 2026 issue of Healthcare Hygiene magazine.

Despite advances in surgical technique, technology, and infection prevention and control (IPC) sciences, SSI persist as one of the most common healthcare associated infections (HAI). Surgical site infections are associated with increased morbidity, mortality, and cost, and negatively impact patient satisfaction and publicly reported quality metrics. While clinical guidelines provide a clear framework to prevention, success ultimately depends on consistent execution across complex perioperative systems.

The reduction of SSI is not solely a technical or clinical challenge; it is a leadership imperative. Perioperative leaders occupy a pivotal position within surgical services, uniquely positioned to influence interdisciplinary teams and align organizational priorities. Effective leadership is essential to translating evidence into practice and sustaining reliable performance over time.

Establish Shared Accountability Across Disciplines

A foundational step in reducing SSIs is establishing shared accountability among all members of the surgical team. Infection prevention initiatives that are perceived as nursing-driving or compliance-focused often fail to engage surgeons and anesthesia professionals meaningfully. Perioperative leaders must intentionally frame SSI outcomes as a collective responsibility, emphasizing that prevention spans preoperative assessment, intraoperative practice, and postoperative care.

Multidisciplinary governance structures, such as SSI prevention committees with representation from surgery, anesthesia, nursing, sterile processing, and infection prevention, reinforce shared ownership and accountability is distributed equally, teams are more likely to engage in problem solving and adapt consistent practices.

Leveraging Data to Drive Engagement and Improvement

Data transparency is essential for improvement; However, the manner in which data are presented significantly influences stakeholder response. Perioperative leaders should use SSI data as a catalyst for inquiry rather than a mechanism for blame. Presenting trends, risk adjusted outcomes, and case level analysis in a non-punitive context encourages engagement and collective learning.

Structured case reviews and interdisciplinary discussion allowed teams to identify system level gaps, such as breakdowns in antibiotic administration, temperature management, or environmental controls. When leaders emphasize learning and improvement, data becomes a shared tool for advancing patient safety rather than a source of divisiveness.

Developing Surgeon and Anesthesia Champions

Physician engagement is critical to successful SSI prevention. Identifying and supporting surgeon and anesthesia champions can significantly accelerate adoption of evidence-based practices. Champions serve as credible peer advocates who can influence professional norms and reinforce expectations with their specialties.

Structured case reviews and interdisciplinary discussions allow teams to identify system-level gaps, such as breakdowns in antibiotic administration, temperature management, or environmental controls. When leaders emphasize learning and improvement, data becomes a shared tool for advancing patient safety rather than a source of defensiveness.

Aligning SSI Prevention with Organizational Priorities

Administrative support is essential for sustaining SSI prevention efforts. Perioperative leaders must clearly articulate how SSI reduction aligns with organizational priorities, including patient safety, regulatory compliance, financial performance, and reputation management.

Perioperative leaders should collaborate closely with these champions, involving them in protocol development, data review, and education efforts. Champions should be selected based on clinical credibility and peer influence rather than formal leadership roles alone. Peer-to-peer communication remains one of the most effective mechanisms for driving behavioral change in the surgical environment.

Standardizing High-Impact Practices While Respecting Clinical Judgment

Variation in perioperative practice is well-documented contributor to inconsistent outcomes. Leaders should prioritize standardization of high-impact, evidence-based practices such as antimicrobial prophylaxis, shin antisepsis, hair removal, normothermia, glycemic control, and operating room traffic management.

At the same time, perioperative leaders must respect clinically justified variation. Engaging surgeons and anesthesia professionals in the development of standardized protocols ensures that guidelines reflect current evidence while preserving appropriate clinical judgment. This collaborative approach promotes adherence and reduces resistance.

Empowering Frontline Staff and Promoting Psychological Safety

Frontline perioperative staff play a critical role in SSI prevention but may hesitate to speak up in hierarchical environments perioperative leaders must actively foster psychological safety by modeling respectful communication, responding constructively to concerns, and reinforcing that speaking up is an expected professional behavior.

Supporting staff who identify potential risks or call for corrective action reinforce a culture of safety and reliability. Empowered teams are better equipped to prevent errors and maintain consistent execution of IP practices.

Sustaining Improvement Through Continuous Leadership Focus

Sustainable SSI reduction requires ongoing leadership attention rather than short-term campaigns. Perioperative leaders should integrate SSI prevention into routine operations through continuous monitoring, regular feedback, education, and performance review.

Celebrating improvements are recognizing teams’ high reliability reinforces positive behaviors and maintains engagement. Continuous improvement frameworks ensure that gains are sustainable despite staff turnover, procedural changes, or increased surgical complexity.

Conclusion

Reducing SSIs requires more than adherence to protocols; It requires leadership capability of influencing culture, behavior, and interdisciplinary collaboration. Perioperative leaders are uniquely positioned to drive this change by fostering shared accountability, leveraging data effectively, empowering champions, and supporting frontline teams. When SSI prevention is embedded into organizational priorities and daily practice, the result is safer surgery, stronger teams, and improved outcomes for patients. Leading change that matters ultimately means leading in ways that protect patients at their most vulnerable moments.

David Taylor, MSN, RN, CNOR, is executive healthcare consultant and principal of Resolute Advisory Group, LLC He is a dynamic, highly respected healthcare executive with extensive enterprise-level leadership experience and a proven record of driving innovation, operational excellence, and measurable improvements in patient care, safety, and system-wide efficiency. Skilled in aligning clinical and operational strategy, leveraging technology and data-driven insights, and building high-performing teams to advance quality, revenue, productivity, and cost containment. Recognized thought leader and national speaker committed to advancing best practices and delivering innovative, patient-centered care through collaboration, education, and strategic vision.