At the three hospitals in the Asante health system, the process for preventing central line-associated bloodstream infections is designed to proceed in exactly the same way.
The nurse manager in each unit is tasked with rounding on all patients who have a central venous catheter to check if it’s clean and properly in place. To do this, she begins each shift by logging onto her personalized dashboard, which is available through the electronic health record system. There she can view all the patients on her floor who have a catheter in place.
Before Medford, Ore.-based Asante rolled out a new EHR a few years ago, catheters were tracked in a paper log by nurses and infection preventionists who were in charge of follow-up. This likely meant some patients with catheters were being missed, said Dr. Jamie Grebosky, Asante’s chief quality officer.
Now if errors or incorrect procedures are observed—using Epic Systems Corp. software—the manager speaks with the nurse in charge of that patient to discuss proper catheter maintenance. Finally, they decide when the catheter can be removed to prevent an infection.
Mitigating variation in performance across hospitals is a central quality improvement strategy for Asante and the 14 other health systems recognized this year by IBM Watson Health as the 15 Top Health Systems.
The health systems rely on evidence-based practices, technology and teamwork to implement standard processes that aim to improve quality of care. “The results are always going to be better if we do it together rather than one place at a time,” said Lynn Britton, CEO of Chesterfield, Mo.-based Mercy, which was recognized by IBM Watson Health for the third time.
At Asante, its workflow was implemented systemwide in 2015 by clinicians who worked together on best approaches to decrease infection rates across the organization. The standard protocols have paid off, with central line-associated bloodstream infection rates across Asante dropping from 1.067 in 2015 to 0.282 in 2017. Asante hasn’t reported such an infection, known as CLABSI, since April 2017.
“We built a standard—this is what it should look like, and we know if we do these things, we will never hurt a patient,” Grebosky said.
Asante’s structured work on CLABSI prevention is in line with the system’s larger goal to mitigate variation in performance across all of its hospitals. The system regularly seeks out ways to standardize care processes so quality of care is the same at every facility.
“If there are best practices for preventing infections and for treating conditions it should be the same no matter where our patients are receiving that care,” said Roy Vinyard, CEO.
Research backs up Asante’s approach, showing efforts to standardize care reduce patient safety incidents and improve quality of care overall.
Standardizing care processes also encourages quality improvement because Asante leaders can more easily benchmark clinical performance and create standard work workflows and expectations for its clinicians, Grebosky said.
“By standardizing work, we have reduced the number of things that people have to do, but they have to do the things they’ve been told to do 100% of the time. Our threshold is perfection. We are going to hold you accountable,” he said.
Article source: http://www.modernhealthcare.com/article/20180421/NEWS/180429995