Hospital Acquired Infections & Quality Improvement

Texas Rural Health Forum Conference, Austin, TexasNovember 10, 2010

Terri Conner, Vice President, TCQPS at THA, Austin, TX

Nicolas Abella, Corporate Dir Med Surg & Critical CareBrownwood Regional Medical Center, Brownwood, TX

Patti R Bull, Infection Prevention CoordinatorHendrick Medical Center, Abilene, TX 

Cheryl Herbert, Executive Director Good Shepherd Medical Center, Longview, Tx

Katherine McDuffie, Education CoordinatorFort Duncan Regional Medical Center, Eagle Pass, Texas

Agenda

Discuss collaborative initiatives that aim to reduce or eliminate HAIs– central-line associated bloodstream and catheter-

associated urinary tract infections

Discuss the importance of these initiatives Roundtable Discussion about rural hospital

involvement

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Healthcare-associated infections

In American hospitals alone, healthcare-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections: – 32 percent of all healthcare-associated infection are urinary tract

infections

– 22 percent are surgical site infections

– 15 percent are pneumonia (lung infections)

– 14 percent are bloodstream infections

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TCQPS/THA HAI Initiatives

On the CUSP: Stop BSI

– Over 30 states are participating in this initiative

– Goal is to reduce CLABSI rates to 1 per 1000 line days

On the CUSP: Stop UTI

– First cohort in Texas begins initiative in January 2011

– Goal is to reduce CAUTI rates by 25% Possible future initiative: On the CUSP: ESRD

– Reduce infection in dialysis units

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CUSP & CLABSI Interventions Project Goals: Two Objectives

Objective #1:Create a Culture of Safety: CUSP

Steps1.Educate on the science of

safety2.Identify defects3.Assign executive to adopt

unit4.Learn from defects5.Implement teamwork &

communication tools

Objective #2:Eliminate CLABSI

Steps1.Educate staff2.Create a central line cart3.Remove unnecessary

lines4.Implement a central line

checklist5.Empower staff to stop

procedure

Why the Initiatives are Important

External Environment– Driven by the belief that hospital care can and

should be safer, more efficient and cheaper: Key point of HHS Secretary Kathleen Sebelius’

initiative to reduce hospital-acquired infections (HAIs)

CMS not reimbursing for HAIs

Public reporting in 2011

CLABSI Initiative in Particular

Preventing Harm– The CDC estimates that 250,000 patients die per

year due to CLABSI Medical costs between $5,700 and $23,000 per

infection

– CLABSIs are not inevitable – we can get to ZERO These reductions have been achieved using the

processes at the core of On the CUSP: Stop BSI

Key Points and Issues – Roundtable Discussion

Culture of Safety– First focus on patient safety

– All initiatives can be implemented easier when the culture enables the effort

Nationally Recognized Standards– Evidence Based Care

– Literature by physicians

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Discussion Continued

Implementation– Resources

Don’t reinvent the wheel – public domain

Non traditional roles

– Commitment

– Barriers Conversations

Data

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Texas Center for Quality & Patient Safety

We encourage your input– What initiatives are you currently working on?

– What initiatives do you think you should be working on? Problem areas – opportunity for improvement

Costly conditions

Terri Conner at tconner@tha.org or 512/465-1021

Maria Rascati at mrascati@tha.org or 512/465-1003

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