State study shows Shands among hospitals with declining infections
Published: Tuesday, August 13, 2013 at 5:00 p.m.
Last Modified: Tuesday, August 13, 2013 at 5:33 p.m.
A statewide report released Tuesday on Florida hospitals shows significant decreases in blood-stream infections, surgical complications and readmissions.
According to the report, produced by the Florida Hospital Association, bloodstream infections fell 41 percent and urinary tract infections by 37 percent; surgical complications fell by 14.5 percent; and readmission rates for various conditions fell by 15 percent — all over about a two-year period in the 107 participating hospitals.
“Back in 2008, we were concerned that we didn't compare well to other states in several areas,” said Bruce Rueben, FHA president, adding that “Florida had a long way to go.”
Rueben said the key to the quick improvement is that hospitals are collaborating instead of competing.
“When you don't have hospitals focused on competing, you get more rapid improvement,” he said.
Dr. Allen Weiss, the chair of FHA's Quality and Patient Safety committee and CEO of NCH Healthcare System in Naples, added, “We may be competitors in a business sense, but it works better when we share best practices. It's become kind of a friendly competition. We aim to be an example for other Florida hospitals.”
Weiss said NCH has gone 44 months without infections in the intensive care unit. Also, its mortality rate from severe sepsis infections has decreased from 46 percent to 13 percent because of an early sepsis alert program that uses a computer system to alert health-care workers when certain parameters have been reached.
“It's like driving a car and having the warning lights go on … seeing it visually, understanding it and responding makes a huge difference,” Weiss said.
UF Health Shands Hospital participated in the program, while North Florida Regional Medical Center did not. Shands' chief quality officer, Randy Harmatz, said Shands has had successful results with the FHA program. The hospital implemented something called CUSP units, which stands for comprehensive unit-based safety programs, which emphasize an interdisciplinary approach to safety oversight involving both nurses and doctors.
Shands also standardized its practice of inserting central lines, which has decreased its central-line infection rate. In December, the hospital was one of 12 nationwide recognized for its low central-line infection rate: Shands reports that no patients have had a central-line infection in three years.
Harmatz said Shands participates in a number of other quality-control collaboratives besides FHA's.
“The benefit of these collaboratives is learning from others and sharing,” Harmatz said. “We're very supportive of FHA's emphasis on quality.”
Harmatz added that Shands has picked up “a lot of points along the way” from other hospitals participating in FHA.
Apart from the clinical benefits to patients or reduced infections, complications and readmissions, Rueben said the improved results carry cost-saving benefits. The decreases cited in the report collectively saved hospitals about $47.67 million.
That's important for a state with 4 million uninsured people, which is a challenge somewhat unique to Florida, Rueben added.
The overall effect of this situation is that people often are seen when they're very sick, cost more to treat and have poorer outcomes.
Avoiding at least some of these costs — those associated with readmissions and avoidable complications — “is a win” not just for patients, but ultimately doctors, Rueben said. That will be especially true with the full implementation of the Affordable Care Act, when “more and more doctors will be paid for outcomes as we move away from fee-for-service,” Rueben said. “We hope that as more people get health insurance and access to primary care, that Florida's going to have an easier time going forward with improved outcomes and a higher health status for the population,” he added.
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