A few week ago, I met Maureen White, RN, from North Shore-LIJ Health System, who told me that the record was now over 2.5 years. This morning, I confirmed that with Jeanine Woltmann, RN, in the Infection Control department.
As of April 30, Glen Cove had gone 1223 ICU patient-days without a central line infection. An outstanding accomplishment by any measure.
How did they do it? Was it some government regulation? Was it incentive payments from the insurance companies or Medicare?
No. They did it because they wanted to do it. Here's the magic solution:
"The superior results at Glen Cove are the result of a collaborative effort between nursing, infection control and physician staff," said Brian Pinard, MD, chief of surgery. "These clinicians have consistently put their motivation and caring into action to reduce the risk of infection while caring for patients."
The culture of patient safety in hospitals has changed dramatically in the last several years, according to Dr. Pinard. He explained that, prior to 2005, there was a common misconception in healthcare that some hospital infections were unavoidable and beyond anyone's control. He said the path to the perfect record began with the hospital's embracing the Institute for Healthcare Improvement's 100,000 Lives Campaign and its emphasis on preventing medical errors and infections.
The hospital's initiatives included communication through daily inter-professional rounds, education, and monitoring of various programs, among them hand hygiene, sterile practices and the use of universal safety protocols. This led to excellent outcomes, improved patient safety, decreased length of stay, a decrease in mortality and cost avoidance, according to Dr. Pinard.
In other words, the people at Glen Cove Hospital do not accept or believe the premise that "these things happen." I again repeat the wise words of Ethel Merman, and also present the original scene from It's a Mad, Mad, Mad, Mad World:Now what kind of an attitude is that, 'these things happen?' They only happen because this whole country is just full of people who, when these things happen, they just say 'these things happen,' and that's why they happen! We gotta have control of what happens to us.
If you cannot see the video, click here.
Congratulations to Glen Cove Hospital. Keep up the good work. I wonder, though, whether or not there was any negative effect on their bottom line. Were they at least rewarded with more patients and a higher market share? These sorts of initiatives would be, at the margin, easier for a hospital’s leadership to embrace if they also paid off financially. While it’s easy to argue that improving patient safety is “the right thing to do,” hospitals that are barely making it financially don’t need any more business headwinds. We should be able to develop ways to reward superior performance in this area.
ReplyDeleteMaybe one has to be an 'of a certain age' doctor to appreciate how truly staggering a shift in paradigm this is. I only mourn for all the patients whose lives were lost while we were still saying "these things happen' all those years.
ReplyDeletenonlocal MD
Perhaps the taste of incentive, or the sound of a whip, must be strong enough to drown the din of human habit.
ReplyDeleteMy guess is that we've entered the realm of frequency-dependent change - 'tipping point' is inexact, as poor care will be tolerated for many years to come. Now there is a cascade of advertising from hospitals that will 'publicly' report measures, as they all jump on the 'we are about quality' bandwagon. But, most measures are required or soon to be required to be public by CMS and I am as skeptical about their oversight as I am about motivations.
The data at Glen Cove, Paul, is at least three years of incredible commitment. Three years ago, who was talking about this? You, and Michael Dowling, CEO of North Shore-LIJ Health System, among only a few others. Leadership is why these things happened. Vocal and values-driven leadership.