| Donna Truesdell says Cooley Dickinson Hospital doesn’t want to be simply above average when it comes to controlling infection and reducing medical errors — it wants to be perfect.That’s a heady goal, but one has drawn the attention of Newsweek magazine, which profiled CDH and several other institutions in its Oct. 16 issue, part of a lengthy feature on efforts to improve the quality of hospital care.
Cooley Dickinson, which was feted for its work in reducing medication errors and other problems, participates in the 100,000 Lives Campaign, an initiative of the Institute for Healthcare Improvement (IHI) that aims to cut down on preventable medical errors and avoidable deaths nationwide.
“Newsweek spoke with IHI and asked for names of hospitals that were working on these kinds of improvements and doing well,” said Truesdell, the hospital’s director of quality improvement. “The recognition is always good, but what’s more important for us is that we’ve set a goal of being a model hospital for quality care, and this is a further reinforcement that we’re on the right path.”
Show Me Your Card
Specifically, Newsweek discussed the yellow, wallet-sized cards that patients are given to keep track of their medications and vaccinations — a concept the article calls a “deceptively simple and mostly affordable” idea, and an effective element in the hospital’s participation in 100,000 Lives.
“There’s nothing sexy about it, no new cures or therapies,” author Mary Carmichael notes regarding the often simple protocols at the heart of the campaign. “But it may end up saving more lives than many pills can.”
Cooley’s efforts to educate patients about medication safety are part of a national trend called medication reconciliation, a process for ensuring that each patient is being administered all intended medications, said Shannon Dillard, RN, quality improvement nurse. Medication reconciliation is one of the six best practices sanctioned by the IHI.
Newsweek also mentioned other low-tech improvements. For example, Cooley Dickinson has dramatically reduced its rate of patients with skin irritations by posting clear signs on patient room doors identifying those more at risk of developing them.
Similarly, physically weak patients also get door markings — in this case a falling star symbol — and the fall rate is down 85{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} since that effort began. And signs depicting bacteria cultured from staff members’ own hands have been an effective reminder of the need to wash up before and after treating patients.
When incidents do occur, Truesdell told The Healthcare News, caregivers must seriously consider what steps can be taken not to repeat them.
“The people who work with the patients need to analyze each situation and say, ‘something has happened. How can we prevent it from happening again?’”
However, she added, those considerations must be a 24/7 habit, not just a response to specific incidents. “What are all the potential things that can go wrong, and how can we avoid them?” she said. “In an ideal world, we would analyze our processes in health care before anything goes wrong, and we’d make them error-free.”
That might seem like a far-fetched goal, but Truesdell told Newsweek that Cooley Dickinson has made an effort to benchmark itself against a standard of perfection, not the average. As an example, she noted that, in March, the hospital had its first case of ventilator-related pneumonia in months.
Thinking there might be a problem with the patient’s breathing tube, respiratory staff found a new kind of tube with a suction device that more effectively kept fluids from entering the lungs. Even though the hospital had recorded no further ventilator-related pneumonia cases since then, all emergency intubations were recently switched to the new tubes.
Uncommonly Good Sense
That’s an example of an improvement that comes with a price tag, she noted, but many successes are simply the result of creativity and common sense.
“Certainly technology helps you,” Truesdell told The Healthcare News, “but for things like infection prevention, so much of the time we’re most successful when we get back to the basics of good health care practices. The tube is an example of the latest technology, but if you don’t do good handwashing, you can have the latest technology and still not decrease your infection rate. So it’s a combination of things.”
It’s also a culture change, she explained, noting that goals mean nothing if nurses and other professionals don’t buy into them, and if hospital administrators don’t create an environment of openness and learning.
“Once you determine the things that need to be done, it’s very important to create systems that make it easy for staff to do them, and do them consistently,” Truesdell said. “It’s that consistency that helps us achieve the outcomes we’re looking for, which are zero infections, zero errors, and 100{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the best practice care.”
And if the national media notices? Well, that’s just gravy. |
