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Experts point to CLABSI reductions, HEN as examples of how hospitals are improving care

January 25, 2013


Central line-associated bloodstream infections (CLABSI) in newborns declined by 58% in less than a year in 100 hospital neonatal intensive care units as part of an AHA Health Research & Educational Trust (HRET) project funded by the Agency for Healthcare Research and Quality (AHRQ), the groups announced yesterday at an AHA panel discussion in Washington, D.C.

“Hospitals are leading the way to enhance patient care through cutting-edge initiatives to improve overall quality and safety,” said AHA President and CEO Rich Umbdenstock, who moderated a panel of government and hospital quality leaders.

 

The nine-state project – part of a larger effort led by HRET to implement the Comprehensive Unit-based Safety Program (CUSP) nationwide – saved 41 lives and more than $2 million in health care costs.

“The CUSP framework brings together safety culture, teamwork and best practices – a combination that is clearly working to keep these vulnerable babies safer,” said AHRQ Director Carolyn Clancy, M.D. “These remarkable results show us that, with the right tools and dedicated clinicians, hospital units can rapidly make care safer.”

A CLABSI occurs when a central venous catheter, or “central line,” becomes infected. Leading the field. The CLABSI results were announced at an event that highlighted how hospitals are working to improve quality through HRET’s Hospital Engagement Network (HEN).

Supporting the Centers for Medicare & Medicaid Services’ Partnership for Patients campaign – a public-private project that seeks to help hospitals adopt practices that have the potential to reduce inpatient harm and readmissions, HRET helps identify solutions already working to reduce health care-acquired conditions, and shares them with the nearly 1,600 hospitals participating in the HEN. The HEN also provides training programs to help hospital leaders improve patient care and assists in establishing a system to track progress in meeting measurable goals.

Maulik Joshi, HRET president and AHA senior vice president of research, presented preliminary results from the first year of some HEN efforts, which show significant reductions in early elective deliveries, catheter-associated urinary tract infections and readmissions.

“This is just one year in, but it shows the progress we can make in a short period of time in quality improvement,” Joshi said. Hospitals’ success stories. Participating in the panel, Jonathan Perlin, M.D., president of clinical and physician services and chief medical officer for HCA, described how the Nashvillebased health system instituted a “hard stop policy” to reduce elective deliveries of newborns before 39 weeks of gestation. “We were able to reduce the rate from what is thought to be the national rate of 15% early elective delivery to a benchmark rate of about 4%,” said Perlin, an AHA board member. The AHA board last year endorsed policies to eliminate early-term, nonmedically necessary deliveries.

Hospital leaders from Arizona and Indiana also shared success stories. Harry Alberti, M.D., chief medical officer and vice president of medical affairs at Verde Valley Medical Center in Cottonwood, AZ, said implementing process improvement strategies, safety checklists and other tools have helped the rural hospital go three years without a CLABSI or ventilator- associated pneumonia (VAP).

Martin Padgett, president and CEO of Clark Memorial Hospital in Jeffersonville, IN, said his hospital has not had a VAP infection since 2010, and it has reduced its medically unnecessary early elective deliveries to zero. “Clark Memorial Hospital creates and promotes a culture wherein patient safety is paramount through education and ongoing training, regular measurement and reporting of key quality safety indicators and consistent application of process improvement practices,” he said.


By Pete Davis