By Paul Gallese
Every patient has a story to tell. And the family members and friends of patients have experiences to share, too. Many of their stories have to do with healthcare-acquired infections or conditions (HAIs and HACs), unfortunately – preventable adverse events that occur due to patient safety lapses.
The incidence of healthcare-acquired infections and conditions is increasing, despite a variety of patient safety programs and methods designed to stop these adverse events. A 2017 report published by Castlight Health and the Leapfrog Group shows healthcare-acquired conditions rising across all five types examined in the survey: central line associated bloodstream infections (CLABSI), catheter associated urinary tract infections (CAUTI), site infections after colon surgery (SSI: Colon), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile (C. diff.). Other top 10 preventable healthcare-acquired conditions named by the Agency for Healthcare Quality and Research (AHRQ, 2017) are falls, pressure ulcers and venous thromboembolism (VTE).
As patient safety advocates and other health care consumers become more aware of the adverse impact of healthcare-acquired infections and conditions, these individuals are becoming a loud collective voice for accountability. One person who is demanding this accountability is Kathy Day. I ran across her name in two places while researching this article – in a Consumer Reports article titled “The surprising way to stay safe in the hospital,” which lists the highest- and lowest-rated hospitals for safety, and in a Patient Safety Action Network (2019) blog article titled “This is how I would stop HAIs.”
An ovarian cancer survivor and a registered nurse whose father died from a MRSA infection, Kathy has viewed patient safety from the perspective of a patient, patient advocate and care provider.
She represents a growing legion of healthcare consumers who have a question for health care leaders: how safe is your hospital?
Creating a patient safety marketplace
Lean Binder, president and CEO of the Leapfrog Group, talks about her company’s strategy to create a market for safety in “Six Things Consumers Will Know About You,” an article written by Lola Butcher for Hospitals & Health Networks. “We want hospitals that improve their safety record to get rewarded for it – and hospitals that don’t pay attention to their safety to feel the pinch in the market,” she explains.
Leapfrog’s Hospital Safety Grade website grades hospitals from A to F on their ability to prevent errors, injuries and infections. Leapfrog estimates that patients in hospitals graded D or F face nearly twice the risk of avoidable death as patients receiving care in A-graded hospitals.
Other organizations rating the safety of hospitals and other kinds of healthcare facilities are Consumer Reports Hospital Safety Ratings, The Joint Commission’s Quality Check and Medicare Hospital Compare.
In addition, the Patient Safety Movement Foundation has identified healthcare-acquired infections as a specific challenge and has begun to give five-star rankings to hospitals committing to eliminating preventable deaths.
The reality for healthcare organization leadership is that hospital performance on safety is becoming increasingly monitored and published publicly. This information is available to anyone who searches for it. Leaders who ignore taking action to improve patient safety do at their own risk and – more importantly – at the risk of their patients.
Gathering data to measure safety performance and improvement
Healthcare organizations are finding ways to collect data on various measures of their safety performance as an initial step toward performance improvement. Some hospitals have begun collecting these data from individual providers through automated workflow monitoring solutions (Nour-Omid, 2019) that can help reduce healthcare-acquired conditions such as MRSA infections, falls, pressure ulcers, and VTE.
Automated workflow monitoring can gather more data about compliance with patient safety protocols than direct observation. For example, an academic medical center increased the number of hand hygiene compliance observations from the 1,500 per quarter it achieved doing direct observation to 225,000 observations per quarter accomplished with automated monitoring; during the same time period, the center improved its hand hygiene compliance from 30 percent to more than 70 percent while reducing its infection rate (Vitalacy, 2019).
The same approach to workflow monitoring can be paired with purposeful rounding to decrease the incidence of falls, pressure ulcers, VTE, nurse fatigue, and adverse drug events. By monitoring rounding, healthcare organizations can measure the frequency and timing of nurse-patient interactions, the amount of time nurses spend with patients, the amount of hours nurses work, and the number of miles they walk during a shift. All of these measures of nurse activity help unit managers to assess current performance, set improvement goals, and relieve nurses from stress and overwork – thereby reducing the risk of non-compliance and medical errors.
A Virginia Pilot/Psychology Today article by pediatric psychologist Gretchen L. Watson invites healthcare organizations to make consumers a part of the patient safety solution, reminding them that, for every 1 percent increase in hand-washing compliance, an average-sized hospital saves lives and $40,000 in annual MRSA expenses.
Every patient has a story to tell. Do everything you can to make that story a good one.
Learn more about Vitalacy’s patient safety solutions at www.vitalacy.com.
Agency for Healthcare Research and Quality (AHRQ). Final report: Estimating the additional hospital inpatient cost and mortality associated with selected hospital-acquired conditions. AHRQ publication No. 18-0011-EF, November 2017.
Butcher L. Six things consumers will know about you. Hospitals & Health Networks. June 9, 2015.
Castlight and The Leapfrog Group. Healthcare-Associated Infections. Data by hospital on nationally reported metrics. 2018.
Consumer Reports. The surprising way to stay safe in the hospital. December 2014.
Day, K. This is how I would stop HAIs. Patient Safety Action Network blog. Jan. 9, 2019.
Nour-Omid J. Vitalacy blog. Introducing Vitalacy’s latest product updates: workflow monitoring & purposeful rounding. Feb. 20, 2019.
Vitalacy, Inc. Finding new ways to prevent healthcare-acquired infections and conditions. 2019.
Watson GL: Making hospitals safer, healthier. The Virginia Pilot, Jan. 29, 2017, and
Psychology Today, Jan. 30, 2017.