Becker's Clinical Quality & Infection Control

Infection Control & Clinical Quality March/April 2014 • Vol. 2014 No. 2 INDEX Table of Contents p. 4 Managing Chronic Conditions p. 6 Hand Hygiene p. 7 Executive Briefing: Patient Warming p. 9 Patient Safety p. 13 Does Hot Water Improve Hand Hygiene Efficacy? A new study finds hot water may not be necessary for proper hand hygiene practices. p. 7 Boston Medical Center's 89% Alarm Reduction How a BMC alarm fatigue pilot reduced alarms to improve patient safety. p. 13 Are Adverse Events on the Decline? One study examining cardiac- related adverse events suggests so. Find out more. p. 13 Patient Navigators Role in Facilitating Successful Chronic Care Management How Cleveland Clinic uses community based health-sup- port systems to better manage diabetes patients. p. 6 High-Price Doesn't Mean High-Quality for Hospitals By Helen Adamopoulos High-price hospitals perform much better than their low- price counterparts on reputation-based quality rankings, but they don't fare so well when it comes to outcome-based measures, according to a Health Affairs study. The study found high-priced hospitals are the clear win- ners when it comes to U.S. News & World Report rankings, which are partly (32.5 percent for the best hospitals of 2013 to 2014) based on their reputation with specialists; none of the low-priced hospitals studied was nationally ranked by U.S. News & World Report for cancer, cardiology or ortho- pedic care. However, low-price hospitals performed better on some measures of excess readmissions and patient safety. Researchers uncovered these findings after analyzing 2011 facility claims for current and retired autoworkers and their dependents younger than 65 in 10 metropolitan areas. The study involved 110 short-stay, Medicare-certified hospitals reimbursed through the inpatient prospective payment sys- tem, with price calculations based on 24,187 inpatient stays. Tackling Diabetes Management at Catholic Health Partners By Ken Bertka, MD, Chief Medical Officer, Mercy Medical Partners & Mercy Clinically Integrated Network As one of the triple aims of healthcare reform, im- proving population health is critical for hospitals and health systems. One of the major focuses of popula- tion health efforts is chronic disease management, as chronic diseases affect a large portion of the popula- tion, and self-management can prevent other medical complications. For example, diabetes increases the risk of heart disease and stroke, among other issues. Maintaining blood sugar and blood pressure control, however, can help to mitigate these risks. With 8.3 percent of the U.S. population living with diabetes, we as healthcare providers have the opportunity to improve the lives of millions of people by helping pa- tients manage their condition. Hospital-acquired infections affect approximately 440,000 patients each year in the U.S., costing roughly $10 billion a year. Largely preventable, healthcare organizations across the country have long focused on re- ducing HAIs; yet, HAIs continue to plague our nation's hospitals. One of the most effective ways to reduce HAIs is proper hand hygiene practices; however, many organiza- tions fall short when it comes to hand hygiene compliance. The reasons for this failure are fairly straightforward: physicians and staff are busy, and sometimes forget or forgo hand hy- giene because it can be inconvenient. In an effort to improve hand hygiene practices across the industry, the Joint Commission Center for Transform- ing Healthcare in 2010 approached a number of leading healthcare organi- zations, asking them to join together to share and test best practices for im- proving hand hygiene. Cedars-Sinai in Los Angeles was one of the organizations approached, and it quickly signed on to participate. Its hand hygiene performance at the time was around 70 percent, and the orga- nization's top leaders felt improve- ment in this area was critical to the system's efforts to reduce HAIs across the organization. "We were interested in participating because one of our performance im- provement principles is to seek out methods of learning of from others," explains Thomas Priselac, president and CEO. Cedars-Sinai's involvement certain- ly paid off. The organization now tracks hand hygiene on a monthly basis organization-wide, and per- formance is broken down by depart- ment, so the medical staff, environ- mental services team and all other employee groups can see how their performance is tracking. Within a year of its efforts to improve hand hygiene, the organization was able continued on page 6 continued on page 5 continued on page 5 The Road to Eliminating HAIs: Hand Hygiene Improvement at Cedars-Sinai By Lindsey Dunn

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