Saturday, December 03, 2011

Things are cooking at Cook's

#IHI As a kind of warmup to this week's IHI Annual National Forum, I am currently at the Annual Meeting and Quality Congress of the Vermont Oxford Network, a group of over 1000 neonatal doctors and other professionals who gather together to share stories of patient care advancement.  I was asked to give a keynote address, but as usual, I learned more than I imparted.  Here is a great story told by Tammy Hoff, RN, from Cook Children's Medical Center in Fort Worth, Texas (seen here with BIDMC's John Zupancic).  They made a concerted effort to reduce the rate of central line infections in their level III-C NICU (750 admissions per year, average census 55).  They used methods from the Institute for Healthcare Improvement and Pediatrix medical group and have been a rate of zero for many months.  Here are the key slides:

What were the costs to the hospital?

Tammy noted:

In order to establish the line team, we had to give up two nursing positions.

Since the establishment of this team and with the success of the program, we have since been able to get those two nursing positions back and filled.

The overall greatest expense in this process is in the risk of taking the first step:  To hire a dedicated team that can focus on nothing but infections and the development of best practice.

Since the inception of this team an expense, but one that we are willing to accept, is the travel to different conferences and programs around the country to share out story.

Here are the benefits, more generally, for society, using Peter Pronovost's CLABSI Opportunity Estimator tool:


Anonymous said...

Wait a minute...Didn't we already show (some years ago) that safety quantified is worth it? Don't we already know, from every angle, that harm costs more than health?

Are we responding to the tobacco industry now? Are they mocking us into expending (more) limited energy just to argue what we know? Will 2021 find us here?

If you want science, then demand science. If you want to win an argument without waiting another half century, switch insurers, drive to a suburban hospital, ask your doctor what his infection rate is, or what he can offer that a competitor cannot. Walk away, and tell them why.

Reality is stressful. I need a cigarette. I think that I'll buy another pack. And wait for more data. Just like they are hoping I will do.

(You go, Paul. This one doesn't taste so well).

e-Patient Dave said...

Man, you really put a burden on your readers with your cutesy post titles. :-) When this one arrived in my always-overfilled inbox, I had no idea it was an ENORMOUS update on central line infections, a topic of great interest to me and which I've followed here for five years!

TWO YEARS without a single central line infection! TWO YEARS!

And their methods are published, for anyone else to adopt.

Seems to me, at some point we'll need to start claiming that ANY central line infection is malpractice, and any death from one is a Wrongful Death, for legal purposes. Because they are, evidently, preventable.

Thomas said...

Can you refer me to their protocol(s)?

Chief Of Stuff

Paul Levy said...

Contact Tammy.