With attention focused on rising costs of healthcare, infection rates play a big role.Â Healthcare-associated infections are on the rise throughout the country, adding extra days, extra time of doctors and nurses and extra meds, all of which add up quickly. The average extra cost to a hospital for treating a patient who becomes infected is $27,000, adding $10 billion a year to the countrys healthcare bill.Â What if a solution was as simple, in some cases, as changing the location of storage for gowns and gloves?
A Washington, D.C.-based not-for-profit, the Plexus Institute, has been working to combat methicillin-resistant Staphylococcus aureus (MRSA), which is one of the most common and hardest to beat of hospital-acquired infections. In a study carried out in partnership with six major hospitals, the Robert Woods Johnson Foundation and the Delmarva Foundation ICU infection rates were cut 65 percent to 70 percent and in some cases to zero.Â
The work is described in the recent book "Inviting Everyone: Healing Healthcare through Positive Deviance" by Plexus authors Arvind Singhal, Prucia Buscell and Curt Lindberg.
Its been known for 160 years that the keys to infection reduction are simple behavioral precautions such as wearing gloves and washing hands.Â But in the hectic and overworked world of todays hospitals, hospital staff often fails to take these necessary steps even when they are aware of the dangers.
Taking the tack that preventing MRSA infection is not a scientific, medical, or technical problem, but is instead a complex social and behavioral challenge; Plexus identifies and works to change systemic barriers to compliance.Â As Lisa Kimball, president of Plexus, says Knowledge doesnt change behavior. In fact, as she points out, most healthcare institutions actually have systems in place that work against effective precautions.Â In one institution, for example, it turned out that glove supplies were on a different floor from nurses and staff.Â
The Plexus methodology identifies such barriers and pinpoints small actions that can be taken to combat them.Â One approach, called positive deviance, is based on the idea that there are individuals and groups who find better solutions to problems than their peers.Â Plexus facilitates discovery and adaptation of these solutions by the people who work in a particular healthcare system on the premise that ideas for change are more eagerly accepted when they come from within than when they are imposed by outside experts.
Participating hospitals in the study were Albert Einstein Medical Center in Philadelphia, Johns Hopkins Hospital in Baltimore, Billings Clinic in Billings, Mont., Franklin Square Hospital Center in Baltimore, University of Louisville Hospital in Louisville Ky., and the VA Pittsburgh Healthcare System in Pittsburgh Pa.Â They are at the hub of a network of collaborating hospitals and not-for profits that carry on work themselves after a Plexus engagement.
Plexus Institute, formed in 2000, grew out of an alliance of 2,200 nonprofit and community hospitals and physician practices seeking to make sense of the conflict and confusion in the healthcare arena and ultimately, to improve the health of people.