4 healthcare leaders on their 2021 patient safety goals, wins
According to the World Health Organization, one in ten patients are harmed while receiving hospital care in high-income countries. WHO also estimates that among Organization for Economic Co-operation and Development countries, including the United States, 15% of hospital spending comes from addressing patient safety concerns.
A January 2020 Yale School of Medicine study found 22,000 preventable inpatient deaths per year in the United States, and health officials are working to reduce that number.
Here’s what four health leaders said Becker Hospital Examination on their patient safety goals and wins this year.
Note: Answers have been edited slightly for style and clarity.
Question: What patient safety goals have you and your organization set for 2021?
Scott Hayworth, MD. CEO, CareMount Health Solutions (Westchester, NY):
For 2021, one of the big areas we have focused on [at CareMount] are perioperative care. As we move low-risk surgeries and procedures from hospitals and CHWs to our in-office surgical suites, we have developed practices to ensure patient safety and comfort. For example, we integrate quality assurance processes and standardize patient care workflows across our 17 in-office surgeries to maintain the same quality of care at every site.
David Christensen, MD. Senior Vice President of Medical Affairs, Valley Children’s Healthcare (Madera, CA)
Our Board of Directors and CEO have mandated that we eliminate all harm to patients. As such, we have set our nosocomial disease targets at zero. We worked with [the Children’s Hospitals’ Solutions for Patient Safety Network] and other children’s hospitals to incorporate best practices and learn from each other.
David Lee, MD. Senior Vice President and Marketing Director, Virginia Hospital Center (Arlington):
Our 2021 patient safety goals are to reduce hospital-wide mortality for heart and lung conditions, stroke, and in particular sepsis. Nosocomial infections are always a concern, so care should be taken to avoid central line infections and urinary tract infections.
Since the hospital is so busy, throughput is a concern – things like emergency department flow, decreased length of stay, and robust home / outpatient care to avoid unnecessary hospitalizations .
Q: What patient safety goals are you on track to meet or exceed, and what do you attribute that to?
Brian Kaminski, DO. Vice President of Quality and Patient Safety, ProMedica (Toledo, Ohio):
While our rate of serious safety events may fluctuate over time, in the past 24 months alone we have reduced our rate by about 50%, after increasing slightly the previous year.
Evidence-based practices, data-informed decision-making and the development of care pathways have enabled our system to provide safe, high-quality care with limited and rapidly changing information. We have even gone so far as to convert an existing hospital to care only for COVID-19 patients, capitalizing on an integrated and highly engaged model of care delivery. The results of this model are evident in the better than expected outcomes of our patients and the continued deployment of many of our methods throughout the various waves and spurts in our community.
Likewise, we take an approach to specifically treat surgical site infections. An evidence-based multidisciplinary practice team was assembled. They reviewed and synthesized the available literature and identified the “dirty dozen” of evidence-based practices that have demonstrated a reduction in surgical site infections based on the best available research. The “dirty dozen” will be deployed through a [enhanced recovery after surgery] platform for specific high-risk surgical procedures throughout the system. We hope to see an even greater reduction in our serious safety events by combating these infections using evidence-based standards.
Dr Hayworth: One of the many benefits of being part of a multispecialty group is that we are able to leverage the expertise of many specialties to inform our policies and clinical guidelines. Most recently, we have reviewed and updated our pacemaker policies for CareMount in-office surgical practices.
A working group from the Departments of Cardiology and Anesthesiology at CareMount reviewed our current practices and advised, among other things, that leadless pacemakers should be added to the exclusion criteria as these pacemakers do not have magnetic response, which makes them difficult to manage in the office. setting. Leadless pacemakers are relatively new technology and are not yet a common consideration in most non-cardiologic practices.
Dr Christensen: We recently went through a 17 month period without central infection for our entire system. Essentially, we have kept our rates at zero in just about all hospital-acquired conditions or have met our improvement targets in all HAC categories this year.
The COVID pandemic has added a layer of complexity to our quality and safety efforts. Despite this, we have succeeded in integrating the safety of our patients into our culture. This was done through transparency of results, learning from each situation, a non-punitive approach to improvement, and frequent celebrations when milestones are met.
Dr Lee: The Virginia Hospital Center is on track to meet or exceed our safety goals in many areas.
For mortality rates, we collaborated with the Mayo Clinic to emulate best practices: a multi-faceted approach with strong nursing care, good protocols and procedures, and the use of the Epic EHR platform to identify patients at risk. deterioration. We have created rapid intervention teams, in conjunction with hospital medical staff, to intervene.
Another initiative we launched this year follows patients who leave the hospital with acute myocardial infarction and heart failure. This can be a difficult population to keep healthy, which is why we have assigned a nurse to work with hospital physicians to identify patients with these diagnoses. This specialist nurse meets them, coordinates internal care, and then follows them after discharge. Everything from placement to medication management, physician follow-up, social services and dietary needs are assessed and addressed.