Delaware Valley Hospitals Improve On Key Infection-Prevention Measures

December 7, 2006 – 6:37 pm | posted in Infectious Diseases, Public Health

Southeastern Pennsylvania hospitals significantly enhanced their infection-prevention capabilities as a result of the groundbreaking Partnership for Patient Care, a multi-year, quality-and- patient-safety effort by hospitals throughout the region. First-year results from the program were announced today at a meeting attended by over 100 senior hospital executives. The Partnership for Patient Care is led by the Health Care Improvement Foundation (HCIF) with strong support from the Delaware Valley Healthcare Council and Independence Blue Cross. The objective of this multi-year project is to make the Greater Philadelphia area the safest place in the nation to receive health care.

While the new safety improvements have only been in place for a few months, overall hospitals throughout the five-county region achieved:

– A 27 percent improvement in controlling blood sugar levels in surgical patients, strengthening the ability of their immune systems to fight infections;

– A 21 percent improvement in the use of antibiotics before surgery to prevent infections; and

– A 9 percent improvement in adopting new safety measures to prevent bloodstream infections from intravenous central lines inserted into main veins to deliver drug therapies and other kinds of medical care.

“I want to acknowledge the hard work of hundreds of area health care professionals and to congratulate them on implementing important additional ways of combating infections,” said Andrew B. Wigglesworth, president of Delaware Valley Healthcare Council and the Health Care Improvement Foundation, the organization managing the Partnership for Patient Care.

“These partial-year results demonstrate the power of working together on our effort to make the Philadelphia area the safest place in the nation to receive care,” Wigglesworth said. “We look forward to even greater improvement over the coming year.”

“Independence Blue Cross is dedicated to providing access to high-quality health care for our members in this region,” said Joseph A. Frick, president and chief executive officer for Independence Blue Cross, the region’s largest insurer. “We believe strongly that the Partnership for Patient Care is a model that other areas of Pennsylvania and the country can use to address the critical issues related to patient safety, including hospital-acquired infections.”

Promoting Best Practices Throughout the Region

To improve the quality and safety of health care throughout the region, the Partnership for Patient Care used a collaborative approach to encourage the rapid adoption of best practices, also known as evidence-based medicine. With the help of ECRI, a nonprofit, Plymouth Meeting-based research agency, hospitals used a method called Failure Mode and Effects Analysis to chart and analyze hospital processes with the aim of finding new or improved ways to prevent infections. Working together in workshops and through an interactive, web-based work site, hospitals shared clinical experience, knowledge, analyses, and solutions, quickly implementing evidence-based best practices and avoiding “reinventing the wheel” on a hospital-by-hospital basis.

This marks the first time in the nation that Failure Mode and Effects Analysis, which has been endorsed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), was used in a large-scale, multi-hospital collaborative. The program also allowed hospitals to meet key goals and requirements of JCAHO, National Quality Forum Safe Practices, Institute for Healthcare Improvement 100,000 Lives Campaign and the Surgical Care Improvement Program.

“The Partnership for Patient Care saved us countless hours of work and analysis,” said Ana Pujols-McKee, MD, Chief Medical Officer and Associate Executive Director, Penn Presbyterian Medical Center, University of Pennsylvania Health System. “Without this program, many hospitals would be working in isolation, needlessly duplicating the process of researching and developing evidence-based practices and protocols. The program’s tools and template policies allowed us to more rapidly adapt and implement new patient safety interventions at our hospital.”

Partnership for Patient Care’s Quality and Safety Efforts in 2007

The Health Care Improvement Foundation and Independence Blue Cross outlined the partnership’s plans for next year including:

– A regional campaign to reduce the incidence of MRSA (methicillin resistant Staphylococcus aureus), an antibiotic-resistant bacteria that can cause serious disability, and even death, in patients. MRSA, a fast-growing health concern, is found in both hospitals and community settings.

– A safety program that improves the management of blood-thinner medications and helps reduce serious complications, such as bleeding or stroke, which can occur when these medications are not properly controlled. This initiative will be conducted in partnership with the nationally recognized Institute for Safe Medication Practices. — The continuation of Failure Mode and Effects Analysis with two new crucial patient safety goals:

– Improving coordination of medications between inpatient and outpatient settings for patients receiving care from several different providers. These patients are at increased risks for medication errors due to unsuspected drug interactions, inappropriate dosages or other drug contraindications. The effort to coordinate a patient’s medication regimen is called “medication reconciliation.”

– Preventing risks of serious and potentially life-threatening blood clots in surgical patients.

– Continuation of work on the three safety improvement initiatives begun in 2006 that focus on controlling blood sugar levels in patients undergoing surgery; improving the use of antibiotics before and after surgery to prevent infections; and preventing bloodstream infections from central lines, special intravenous lines used in deep veins.

To support 2007 efforts, Independence Blue Cross will contribute $250,000 and area hospitals will provide approximately $600,000 for a total of nearly $850,000. In a tremendous commitment to region-wide patient safety, Hahnemann University Hospital provided $225,000, making it the largest individual hospital contributor. Independence Blue Cross has also pledged another $250,000 for 2008. These amounts are in addition to Independence Blue Cross’s leadership contribution of $750,000 to support 2006 efforts.

“I want to commend Independence Blue Cross, our region’s primary health insurer, for not only supporting this initiative financially, but being an active participant in the design of this program,” said HCIF board chair, Michael B. Laign, president and CEO of Holy Redeemer Health System. “It’s one more concrete demonstration that hospitals and Independence Blue Cross are united in our shared commitment to patient safety.”

The Partnership for Patient Care marks a continuation of Independence Blue Cross’s involvement with the Health Care Improvement Foundation’s ongoing, successful patient safety initiatives. Previously, Independence Blue Cross and hospitals teamed up on the nationally recognized Regional Medication Safety Program for Hospitals. JCAHO has called this program one of the top five large-scale medication safety collaboratives in the nation.

“We anticipate the Partnership for Patient Care - like the Regional Medication Safety Program for Hospitals before it - will become a national model. The program provides tools and resources to help enhance the considerable ongoing individual efforts by hospitals and health systems to more rapidly implement best practices in the Delaware Valley,” Wigglesworth said.

About the Delaware Valley Healthcare Council

The Delaware Valley Healthcare Council is a membership organization representing more than 150 healthcare organizations in Pennsylvania, southern New Jersey and northern Delaware. Its mission is to assist member organizations to improve the health status of their communities and to exercise leadership in the appropriate restructuring of the regional healthcare delivery system through advocacy, information and education in the public interest. DVHC is an affiliate of the Hospital and Healthsystem Association of PA. Its website is located at: http://www.dvhc.org.

About the Health Care Improvement Foundation

The Health Care Improvement Foundation (http://www.dvhc.org/hcif) is a non-profit foundation and a strategic partner of the Delaware Valley Healthcare Council. Its mission is to support innovative efforts to improve health services and enhance public trust and confidence in the region’s healthcare delivery system through the promotion of best practices in community health and patient safety in the Delaware Valley.

About Independence Blue Cross

Independence Blue Cross is the primary health insurer in Southeastern Pennsylvania. Nationwide, Independence Blue Cross and its affiliates provide coverage to nearly 3.4 million people. For nearly 70 years, Independence Blue Cross has offered quality health care products and services tailored to meet the changing needs of members, employers, groups and providers. This year, Independence Blue Cross’s Personal Choice was rated the No. 1 PPO in the nation and its Keystone HMO was ranked as the No. 1 HMO in the region by health care consumers in a leading independent consumer magazine. For more information, visit http://www.ibx.com.

About ECRI

ECRI (http://www.ecri.org) is an independent, non-profit health services research agency that focuses on improving the safety, quality and cost effectiveness of health care. It is designated as an Evidence-based Practice Center by the U.S. Agency for Healthcare Research and Quality and is a Collaborating Center of the World Health Organization (WHO).

About ISMP

The Institute for Safe Medication Practices (http://www.ismp.org) is the nation’s only nonprofit organization devoted entirely to medication error prevention and safe medication use. Known and respected worldwide as the premier resource for impartial, timely and accurate medication safety information, the organization has over 30 years of experience in helping health care practitioners keep patients safe.

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