By focusing on reducing early elective deliveries and hospital-acquired infections, a collaborative called Patient Safety First (PSF) has helped California hospitals avoid 3,576 deaths and more than $63 million in unnecessary hospital costs between 2009 and 2012.
PSF is a statewide collaborative between the Hospital Council of Northern & Central California, the Hospital Association of Southern California, the Hospital Association of San Diego & Imperial Counties, Anthem Blue Cross, National Health Foundation and 180 California hospitals with a mission to improve quality and reduce healthcare costs across the state.
Since 2010 – when the collaborative first began – PSF hospitals have shown significant improvement in four hospital-based avoidable harm initiatives that the collaborative has mainly focused on: sepsis mortality, ventilator-associated pneumonia, central line blood stream infections (CLBSIs), catheter associated urinary tract infections (CAUTIs) and perinatal gestational age deliveries under 39 weeks, said Darrel Ng, public relations director for Anthem Blue Cross.
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Of the 180 participating hospitals, 40 consistently reported before and after data for each quarter of the year said Eugene Grigsby, president and CEO of the National Health Foundation. The results from those 40 hospitals showed a 74 percent reduction in early elective deliveries prior to 39 weeks gestational age; a 57 percent reduction in cases of ventilator-associated pneumonia; a 43 percent reduction in cases of CLBSIs; a 24 percent reduction in the CAUTI rate; and a 26 percent reduction in sepsis mortality.
“The importance of the program is showing that when over 180 hospitals identify a problem, utilize a common database and work collaboratively to make hospitals safer, significant progress can be made,” said Grigsby.
PSF uses a peer-to-peer learning model, Grigsby said, which involves periodic meetings set up with hospitals and subject matter experts. “It was about learning from individual hospitals that have already set up a successful plan,” Grigsby explained.
“This coaches and shows some people that under all these conditions with so much to think about, you can still bring about change in a meaningful way.”
At one of PSF’s flagship hospitals – Glendale Adventist Medical Center (GAMC) in Glendale, Calif., – bringing about meaningful change meant setting a zero tolerance policy for hospital-acquired infections, said Arby Nahapetian, vice president of medical affairs and quality at GAMC.
“In the healthcare industry there’s always been a tolerance for bad things that happen at times, and we decided that was unacceptable and aimed for zero,” said Nahapetian.
Whenever an incident happens, he said, it is investigated so that everyone understands what happened and knows how to make sure it doesn’t happen again.
“A lot of this is about culturally changing the tolerance for anything going wrong,” he said.
In a one-year period, GAMC was able to reduce CLBSIs by 60 percent and brought down CAUTI incidences to zero, he said. Additionally, GAMC also reduced its overall risk-adjusted mortality rate by 53 percent.
“This reduction was the result of multiple quality initiatives here. It really speaks to how powerful these initiatives can be,” he said.