Mercy Hospital, part of Allina Hospitals & Clinics, is only one of four hospitals in the U.S. to be awarded an Outstanding Leadership Award from the U.S. Department of Health and Human Services (HHS) for achievements in eliminating two types of healthcare-associated infections (HAIs).
Out of 250 hospitals that applied nationwide, Mercy is the only hospital in Minnesota to earn an Outstanding Leadership Award, the highest level, for eliminating central line-associated blood-stream infections (CLABSI) and ventilator-associated pneumonia (VAP). Out of 2,400 patients who receive care at Mercys intensive care unit every year, there have been no cases of CLABSI for nearly three years and only one case of VAP per year.
"This is an impressive accomplishment that few hospitals have earned because of the difficulty and complexity involved in eliminating these infections," says Mary Jo Morrison, Allinas vice president of performance improvement. "Its also important because these are key quality measures and CLABSI is also one of the proposed measures for accountable care organizations."
Hospital-acquired infections affect about 1 in 20 hospitalized patients and HHS has set a goal of reducing them by 40 percent by the end of 2013, which could save more than 60,000 lives. Eliminating hospital acquired infections is also a focus of the federal Affordable Care Act. The law includes the Hospital Value Based Purchasing Program which will reward larger payments to high performing hospitals. HHS awarded a total of 37 hospitals for making progress in eliminating HAI.
"This award reflects the leadership support and collaboration of our team to continually seek ways to eliminate all healthcare-associated infections, and to ensure every patient receives safe, reliable, yet cost effective care," says Michelle Farber, the infection preventionist at Mercy Hospital.
The Centers for Disease Control and Prevention (CDC) reports that a 58 percent reduction of CLABSI in US ICUs saved $414 million in extra costs from 2001 to 2009. Eliminating CLABSI at Mercy Hospital reduced medical expenses by an estimated $424,000 and resulted in 96 fewer days in the ICU for patients between 2007 and 2010. Preventing VAP saves about $18,000 per patient, according to the 2008 Advisory Board.
The effort to eliminate VAP and CLABSI at Mercy began in 2003 with initiatives that include:
-- New infection prevention protocol. Mercy was one of the first hospitals in 2009 to implement a protocol to bathe ICU patients daily with the antiseptic chlorhexidine gluconate. Scientific research(1) has since proven the effectiveness of this practice in several multicenter trials and is evolving as a best practice among other hospitals in the nation.
-- Early removal of catheter or ventilator. Protocols and order sets allow the ICU staff to wean patients from ventilators and to remove catheters as early as possible. Mercy has shared this early extubation protocol with hospitals across the U.S. and England.
-- Clinical Action Teams. CAT teams focus on one area or opportunity. Teams review literature, implement evidence-based improvements and then hard-wire practices into work-flows. For example, a "Scrub the Hub" campaign highlighted the need to use friction with an alcohol pad for 15 seconds before accessing a port.
In addition to the HHS award, Thomson Reuters ranks Mercy Hospital as one of the top 100 hospitals in the nation. The Agency for Healthcare Research and Quality, the lead federal agency for improving healthcare quality and safety, ranks the culture of safety in Mercys ICU in the top 13 percent in the nation.
1. Daily chlorohexidine gluconate bathing with impregnated cloths results in statistically significant reduction in central line-associated bloodstream infections. Dixon JM, et al. Am J Infect Control 2010; 38:817-21.