Delaware Valley Hospitals Improve on Key Infection-Prevention Measures

PHILADELPHIA -- Southeastern Pennsylvania hospitals significantly enhanced their infection-prevention capabilities as a result of the groundbreaking Partnership for Patient Care, a multi-year, quality-and- patient-safety effort by hospitals throughout the region.

First-year results from the program were announced today at a meeting attended by more than 100 senior hospital executives. The Partnership for Patient Care is led by the Health Care Improvement Foundation (HCIF) with strong support from the Delaware Valley Healthcare Council and Independence Blue Cross. The objective of this multi-year project is to make the Greater Philadelphia area the safest place in the nation to receive health care.

While the new safety improvements have only been in place for a few months, overall hospitals throughout the five-county region achieved:

      -- A 27 percent improvement in controlling blood sugar levels in

         surgical patients, strengthening the ability of their immune systems

         to fight infections;

      -- A 21 percent improvement in the use of antibiotics before surgery to

         prevent infections; and

      -- A 9 percent improvement in adopting new safety measures to prevent

         bloodstream infections from intravenous central lines inserted into

         main veins to deliver drug therapies and other kinds of medical care.

"I want to acknowledge the hard work of hundreds of area healthcare professionals and to congratulate them on implementing important additional ways of combating infections," said Andrew B. Wigglesworth, president of Delaware Valley Healthcare Council and the Health Care Improvement Foundation, the organization managing the Partnership for Patient Care.

"These partial-year results demonstrate the power of working together on our effort to make the Philadelphia area the safest place in the nation to receive care," Wigglesworth said. "We look forward to even greater improvement over the coming year."

"Independence Blue Cross is dedicated to providing access to high-quality healthcare for our members in this region," said Joseph A. Frick, president and chief executive officer for Independence Blue Cross, the region's largest insurer. "We believe strongly that the Partnership for Patient Care is a model that other areas of Pennsylvania and the country can use to address the critical issues related to patient safety, including hospital-acquired infections."

To improve the quality and safety of healthcare throughout the region, the Partnership for Patient Care used a collaborative approach to encourage the rapid adoption of best practices, also known as evidence-based medicine. With the help of ECRI, a nonprofit, Plymouth Meeting-based research agency, hospitals used a method called Failure Mode and Effects Analysis to chart and analyze hospital processes with the aim of finding new or improved ways to prevent infections. Working together in workshops and through an interactive, Web-based work site, hospitals shared clinical experience, knowledge, analyses, and solutions, quickly implementing evidence-based best practices and avoiding "reinventing the wheel" on a hospital-by-hospital basis.

This marks the first time in the nation that Failure Mode and Effects Analysis, which has been endorsed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), was used in a large-scale, multi-hospital collaborative. The program also allowed hospitals to meet key goals and requirements of JCAHO, National Quality Forum Safe Practices, Institute for Healthcare Improvement 100,000 Lives Campaign and the Surgical Care Improvement Program.

"The Partnership for Patient Care saved us countless hours of work and analysis," said Ana Pujols-McKee, MD, chief medical officer and associate executive director of Penn Presbyterian Medical Center at the University of Pennsylvania Health System. "Without this program, many hospitals would be working in isolation, needlessly duplicating the process of researching and developing evidence-based practices and protocols. The program's tools and template policies allowed us to more rapidly adapt and implement new patient safety interventions at our hospital."

The Health Care Improvement Foundation and Independence Blue Cross outlined the partnership's plans for next year including:

      -- A regional campaign to reduce the incidence of MRSA (methicillin

         resistant Staphylococcus aureus), an antibiotic-resistant bacteria

         that can cause serious disability, and even death, in patients.

         MRSA, a fast-growing health concern, is found in both hospitals and

         community settings.

      -- A safety program that improves the management of blood-thinner

         medications and helps reduce serious complications, such as bleeding

         or stroke, which can occur when these medications are not properly

         controlled.  This initiative will be conducted in partnership with

         the nationally recognized Institute for Safe Medication Practices.

      -- The continuation of Failure Mode and Effects Analysis with two new

         crucial patient safety goals:

              -- Improving coordination of medications between inpatient and

                 outpatient settings for patients receiving care from several

                 different providers.  These patients are at increased risks

                 for medication errors due to unsuspected drug interactions,

                 inappropriate dosages or other drug contraindications.  The

                 effort to coordinate a patient's medication regimen is called

                 "medication reconciliation."

              -- Preventing risks of serious and potentially life-threatening

                 blood clots in surgical patients.

      -- Continuation of work on the three safety improvement initiatives

         begun in 2006 that focus on controlling blood sugar levels in

         patients undergoing surgery; improving the use of antibiotics before

         and after surgery to prevent infections; and preventing bloodstream

         infections from central lines, special intravenous lines used in deep

         veins.

To support 2007 efforts, Independence Blue Cross will contribute $250,000 and area hospitals will provide approximately $600,000 for a total of nearly $850,000. In a commitment to region-wide patient safety, Hahnemann University Hospital provided $225,000, making it the largest individual hospital contributor. Independence Blue Cross has also pledged another $250,000 for 2008. These amounts are in addition to Independence Blue Cross's leadership contribution of $750,000 to support 2006 efforts.

Source: Delaware Valley Healthcare Council