Hospitals Already Have the Key Tool Needed to Reach Zero HAIs
Hospitals have declared zero tolerance for healthcare-associated infections (HAIs), and they already have the key tool to do it. However, it has become a massive problem to address.
Recently published in Fierce Healthcare, Dr. Brita Hansen, LogicStream Health Chief Medical Officer, weighs in on the healthcare-associated infections. She notes how some plague health systems and create major consequences for any who haven’t yet determined reduction solutions.
One of the most pressing problems regarding healthcare-associated infections is the implications they have on patients. HAIs such as Clostridium difficile (C. diff) and catheter-associated urinary tract infections (CAUTIs) result in 7% of hospitalized patients at any time. They are responsible for about 30% of patients in intensive care units acquiring at least one HAI, according to the World Health Organization. CAUTI is one of the most problematic, accounting for more than 30% of HAIs, costing health systems about $500 million annually in treatment costs. Medicare also withholds reimbursements from hospitals within a certain high-HAI quartile, and doesn’t reimburse for other HAIs.
Dr. Hansen recognized the immensity of this problem, but also knows that there are solutions hidden within a tool that hospitals already use: their electronic health records (EHRs). There are five specific areas that health systems can and should improve upon if they want to see true progress towards zero HAIs.
Five focus areas
1. Streamline workflows. Removing unnecessary variation in the way care is delivered to ensure clinicians follow the best clinical practices. EHR systems can be leveraged to remind clinical staff that a patient has a catheter and suggest they remove it or document why it is still indicated.
2. Stop overtesting. Hospital staff too often overtest for infections when there are not strong clinical reasons to expect an infection. Use EHR systems to ensure care processes are aligned with current testing guidelines and workflow best practices. That will produce even bigger improvements.
3. Focus on best practices. Getting CAUTI rates to zero means clinicians should set strict rules for testing and focus on the correct insertion, maintenance and removal of catheters. Modifications such as improving catheter protocols ensure clinician focus on best practices throughout the care-delivery continuum.
4. Minimize patient risk of infection. Whether it’s overuse of catheters or antibiotics, more rigorous hospital workflows can minimize infection risk. Many hospitals and health systems still have multidisciplinary teams performing retroactive chart reviews of HAI cases. Rather than reviewing past cases, EHRs can even be set up to proactively make recommendations for clinicians.
5. Improve infection controls. Once an infection is identified in a timely fashion, hospitals need consistent procedures to stop it from spreading. Those should include isolating the patient, clinicians wearing special gowns and gloves, special hand-washing procedures and, crucially, communicating those standards to staff.
About Dr. Brita Hansen: Brita Hansen, M.D., is chief medical officer of LogicStream Health. Prior to joining LogicStream, Dr. Hansen served as chief health information officer at Hennepin County Medical Center. She is also an assistant professor of medicine at the University of Minnesota School of Medicine.