Becker's Clinical Quality & Infection Control

17 QUALITY IMPROVEMENT & MEASUREMENT He noted St. Bernard wasn't reporting a significant number of adverse events due to the scanning issues, "but we knew that by not scanning medications, eventually, something's going to happen. ese processes are in place as safety barriers to prevent errors." What about hospital-acquired infections? Leapfrog's spring 2023 report card showed HAIs are at a five-year high. In fact, hospitals in many states reported spikes in three HAIs — central line-associated bloodstream infections, catheter-associated urinary tract infections and methicillin-resistant Staphylococcus aureus — that "alarmed" Ms. Binder and her team at Leapfrog. Statistical benchmarks are based on e Leapfrog Group's use of the standardized infection ratio, which compares the number of HAIs at each hospital to the predicted number of infections. Mr. Richardson confirmed St. Bernard's data on infections had been high, so he focused on hand hygiene policies, noting, "Everybody realizes that lack of hand hygiene causes hospital acquired infections; it's the biggest cause." St. Bernard hired "secret shoppers," the safety chief said, to manually watch over the process. It was costly and an inconsistent way to monitor compliance. "So we invested in electronic monitoring of hand hygiene practices," he said. "Now the staff wear badges that they scan every time they use a hand sanitizer." A signal light on the badge starts yellow and turns green — "green means clean," Mr. Richardson said — aer the person cleans their hands. e machine beeps aer the person enters a patient's room, every 15 seconds, warning them if they don't comply with hand hygiene policies, the badge turns red and the system will record it. All employees, including Mr. Richardson and his fellow C-suite leaders at the hospital, have been wearing the badges since May 2022. More than 1 million "green lights" have been recorded by the technology in the past year, and St. Bernard hand hygiene compliance is at around 90 percent, far higher than Leapfrog's benchmark. "We are aiming toward a goal of 95 percent compliance," he said, adding the hospital currently is reporting zero CLABSI and zero CAUTI infections. Initiatives to reduce MRSA infections are ongoing. Leapfrog bases its hand hygiene standard, in part, by collecting hand hygiene compliance data on at least 200 hand hygiene opportunities each month, in each patient care unit. Some hospitals say the Leapfrog grades aren't "fair" and don't accurately describe real-time hospital activities because they are based, in part, on the most recent CMS data available. "Leapfrog's guidelines are really the industry's patient safety industry standards," Mr. Richardson said. "Hand hygiene, infections, falls with fractures — all hospitals need to look at these types of issues and do something about them. at's what we did here at St. Bernard." n How HCA Healthcare's 200+ person team preps for hurricane season + beyond By Ashleigh Hollowell A s one of the nation's largest health systems, Nashville, Tenn.-based HCA healthcare facilities extend beyond its home base and into the heart of hurricane territory across Florida, Texas, Louisiana, South Carolina and Georgia. Preparing for the season is routine, unlike the unpredictable storms that pose a threat to patients and clinicians if they make landfall. The preparations and safety training are the responsibilities of HCA's Enterprise Emergency Operations Center team, which is equipped with key resources that it distributes across facilities in high risk areas to ensure continuity of care in case of such an emergency. The 200-person emergency operations team is made up of leaders across departments including clinicians, supply chain experts, risk management executives, patient logistics and care coordination experts, as well as air and ground transport liaisons. Like the health system's headquarters, the special team is also based in Nashville, but it responds to more than 900 events per year across HCA Healthcare facilities nationwide, according to the release. "Our job is to ensure the infrastructure is in place—the supplies, equipment, buildings and everything it takes to deliver care — and that our colleagues and patients are taken care of," Michael Wargo, RN, BSN, vice president of the Enterprise Emergency Operations Center team said in the news release. "We are proud of our response to previous major incidents and strive to make our procedures even more seamless so that continuity of care remains uncompromised." In the event of an emergency like a hurricane, the team can work to coordinate assistance, redirect medical supplies, generators, water and even deploy flood control barriers as needed. If evacuations are necessary, HCA Healthcare uses a proprietary algorithm it developed that provides real-time triage data and can track every patient's movement as well as coordinate where alternative care options might be available for patients. In 2023, the team will supply Incident Support Unit Trailers with storm readiness equipment including 3,000 flood control barriers and station them in both at-the-ready within its Gulf Coast and West Florida divisions. n "We are aiming toward a goal of 95 percent compliance" — Michael Richardson, BSN, RN, chief quality and patient safety officer, St. Bernard Hospital

• Cover