Fighting the HAI Crisis Through EHR Optimization

By Vivian Patterson, RN, BA, PCMH CCE, Delivery Director, Advisory Services, Health Soltuions

In the U.S., Hospital-acquired infections (HAIs) have risen to a crisis level. According to the Centers for Disease Control and Prevention (CDC), on any given day, one in every 25 hospital patients will acquire at least one HAI. Further, about 75,000 patients with HAIs died during their hospitalizations. It is a staggering statistic.

There are many examples of programs that have resulted in reduced infections, such as the Institute for Healthcare Improvement’s (IHI) bundle program, which reported a 50 percent decrease in central line-associated bloodstream infections. However, despite these improvements, there are areas of no change, such as overall catheter-associated urinary tract infections, and more alarming, areas that continue to see an increase such as the rate of hospital-acquired Clostridium difficile (C. diff), which saw a 4 percent increase between 2013 and 2014.

While the IHI bundles rely on process change, we have found, through client experience, that the addition of technology as an enabler can have a significant impact on infection reduction. One community hospital experienced immediate results using this approach.

While they were making progress decreasing infections such as ventilator-acquired pneumonia (VAP) and Methicillin-resistant Staphylococcus aureus (MRSA), they continued to see increases in C. diff infections. With CTG’s help, they were able to significantly reduce their rate of HAIs through EHR optimization.

In order to achieve this, the hospital used a six-step approach:

  • Identify and select the optimization opportunity (in this case, a reduction in C. diff) 
  • Define benefit areas and establish success metrics and goals 
  • Perform rapid assessment (less than five days) with findings and recommendations 
  • Plan and perform baseline measurement; set metrics and targets
  • Implement remediation activities 
  • Provide for continuous improvement with post-go-live metrics and outcomes measures 

Over the course of only three months, these targeted interventions combining quality, evidenced-based care, and technology yielded rapid results, including:

  • 970 percent (10x) improved documentation within a week after go-live
  • Significant direct cost reduction of between 13 and 20 percent in all C. diff patients over the first three-month period
  • An approximate cost savings of $260,000 annually and $1.3 million over five years from C. diff prevention and the resulting reduction in LOS due to early detection and intervention of hospital and community-acquired C. diff cases 

These powerful results resulted from relatively simple technology-powered changes. When you link these real results to pay-for-performance, risk-based contracting, and bundled payments, the value proposition becomes even stronger. 

Not only did this approach improve hospital performance, it also increased patient satisfaction, staff satisfaction, and the organization’s external quality scores. It positioned the organization to meet the goals of the Triple Aim: an improvement in the experience of care, improvement in outcomes, and reduction in costs.

Technology provides a solid foundation and an enabler for the realization of these goals, while also saving lives—a result that cannot be measured in dollars. The link between informatics and quality has never presented a stronger case of the ability to bring healthier outcomes to our hospitals.

For more information on this project read our white paper.

 

 

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