Becker's Clinical Quality & Infection Control

14 INFECTION CONTROL & PATIENT SAFETY HAIs, sepsis and more: 8 leaders share patient safety goals for 2019 By Mackenzie Bean P atient safety is a top priority for healthcare executives, with leaders constantly looking for new ways to achieve a safe and positive healthcare experience for all patients. Becker's Clinical Leadership & Infection Control asked healthcare leaders to share their patient safety goals for 2019. Read their responses below: Note: Responses have been lightly edited for length and clarity. Michele Saysana Vice President of Safety, Quality and Performance Improvement at Indiana University Health (Indianapolis) "In 2019, the system's patient safety goals will once again aim at a long-time adversary — hospital-acquired infections — while adding goal-setting around three new areas: mortality, sepsis and the opioid epidemic. Our efforts against HAIs will target central line-associated bloodstream infections, catheter-associated urinary tract infections and Clostridium difficile infections. is year's goal is to reduce HAIs by about 15 percent. "Our new mortality and sepsis goals will aim to wrap the right pallia- tive services around patients who are in end-of-life stages and address sepsis through better identification and treatment. To fight sepsis, we are leveraging education, simulation training and data resources like EHRs. As opioid abuse continues to challenge Indiana, IU Health has set goals for 2019 that include examining appropriate prescribing and better addiction treatments, and detecting opioid diversion within our system." Mark Jarrett, MD Senior Vice President and Chief Quality Officer at Northwell Health (New Hyde Park, N.Y.) "We all have a lot of safety goals. One of the top goals we're focusing on in 2019 is trying to encourage the reporting of near misses and using near miss data to be proactive in preventing harm, rather than always being reactive based on adverse events. We're rolling out a new incident reporting system in January across the system. We hope to harness the size of the health system to provide data that might be lost if only looking at one or two hospitals. By looking across our 23 hospitals, we're hoping to build a significant database of near misses that will help generate new projects to prevent harm. "e second big goal is boosting patient involvement in our safety processes. In 2018, we started to engage patients more in efforts to improve diagnosis and hope to expand that in 2019. e rationale is that if providers engage the patients with the proper communication, educate them about their conditions and share why they came to that conclusion, it will probably help or stall diagnostic errors." Carole Stockmeier and Craig Clapper Partners in Strategic Consulting for Press Ganey "Transforming the culture within healthcare organizations is im- portant, yet transforming the culture of the healthcare industry is imperative. While we exist as individual organizations, we are all human-based systems. Rather than seeking to be different when it comes to safety, we should strive to be the same when it comes to safety. In safety, we do not compete — we all share and learn from one another. Let our focus in 2019 be on continuing the good work in improving safety within healthcare organizations while advanc- ing efforts to influence and forge a shared safety culture across the healthcare industry." James Hunter, MD CMO of Atrium Health (Charlotte, N.C.) "Before it was part of the national conversation, antibiotic stew- ardship was on our radar at Atrium Health as a key component of infection reduction. We've tracked antimicrobial utilization as a systemwide patient safety goal since 2015 and aim for an additional 5 percent reduction in 2019. "Atrium Health has a dedicated Antimicrobial Support Network for our Charlotte-area hospitals and a robust collaborative that extends to our regional partners. Our experts assist in choosing the optimal selection, dosage and duration of antimicrobial therapy. We measure the total days of therapy for most antibiotics — calculated as the total number of doses dispensed divided by the patient's total inpatient and observation days at the facility — and standardize it to account for our hospitals of different sizes. "e results are dramatic: we've seen a 24 percent reduction in anti- microbial utilization in our Charlotte-area hospitals since 2013, while decreasing the rates of C. diff and MRSA. Since debuting an outpatient antibiotic campaign in fall 2017, we've already observed a 5 percent de- crease in antibiotic prescribing in eligible primary care encounters." Peter Pronovost, MD, PhD Chief Clinical Transformation Officer at University Hospitals (Cleveland) "ere is broad agreement that healthcare needs to improve value, yet there's limited evidence that value is improving. Healthcare costs too much, harms too oen and improves too slowly. e National Academy of Medicine, in fact, estimates that 30 percent of healthcare spending is wasted. University Hospitals has set a goal to address this, namely, to provide the highest value to both those who receive care and those who pay for care. We define value as achieving the highest quality and experience and the lowest possible annual total cost of care. "Applying the principles of high reliability organizing and borrowing from previous work using a checklist to reduce bloodstream infec-

• Cover