The hospital field has made tremendous strides in battling health-care associated infections in recent years, but HAIs remain a pressing problem. One East Coast medical center, however, could teach its peers a thing or two in the push toward zero infections.
At any particular time, one in every 25 U.S. patients has an HAI, according to the Centers for Disease Control and Prevention, and some 75,000 die from such infections. Along with the harm caused, those cases cost the health care system about $33 billion in possibly avoidable costs each year. "These infections can have devastating consequences for patients and their families," Karen DeSalvo, acting assistant secretary for health at the Department of Health & Human Services, said during a webinar on Friday.
With that in mind, HHS, along with partnering institutions, recognized the University of Vermont Medical Center last week with its 2014 Partnership in Prevention Award for its work in addressing such infections. The 562-bed academic medical center has made dramatic progress in tackling HAIs, including a 77 percent reduction in central line-associated bloodstream infections in its medical intensive care unit.
Sally Hess, manager of infection prevention, says a commitment from senior leadership has been one of the keys in the medical center's push toward "getting to zero." Such an achievement isn't a pipe dream, as the organization went three years without a central line-associated bloodstream infection, she notes. Along the way, the medical center has emphasized creating a culture of safety, according to the award announcement, and collaborated across ranks from the C-suite to providers and infection prevention pros.
"Infection prevention is the core of our organization's quality and safety culture," Hess said during Friday's webinar. "It really does take hundreds of people to get this right every day. And so, it's critical that we all practice high reliability and practice to the evidence base every day, and it does take a team effort to get that to happen."
Interventions designed by the medical center include everything from educating and screening patients prior to orthopedic spinal fusions to using checklists and standardized central-line insertion kits and educating and monitoring hand hygiene during outpatient dialysis. You can find more details about the hospital's work in this slideshow from last week's presentation of the award, which, in addition to HHS, is sponsored by the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America.
W. Kemper Alston, M.D., medical director and epidemiologist for the University of Vermont Medical Center, says that some of the biggest hurdles for the hospital in realigning its culture included challenging physicians' autonomy and overcoming skepticism about the data. Physician engagement, he believes, has been crucial in making their efforts successful.
"I'm a firm believer, after having done this for a long time, that infection-prevention people and epidemiologists cannot change these things on their own," he says. "You really have to engage the providers."