Analytics Boost Clinical Best Practices At Tampa General Hospital

Tag Archive: C. diff

1. Analytics Boost Clinical Best Practices At Tampa General Hospital

   October 15, 2018 1:16 pm Leave a Comment

   

    

   A recent article in Healthcare IT covers how Tampa General Hospital used analytics to boost use of clinical best practices. Clinicians reduced one specific test order from roughly 90 per month to five – helping with antimicrobial stewardship along the way. 

   Tampa General Hospital was experiencing difficulty accessing analytics on orders and process workflows. Any information had to come from a custom report which took days to produce. Data wasn’t easily accessible and sometimes led to more questions which put the same time-consuming cycle in motion.

   This process placed an enormous burden on the business intelligence team. They had to endlessly produce report after report so that staff could continue improving hospital quality.

   

   PROPOSAL

   The ultimate goal was to improve sepsis protocol compliance and identify and eliminate outdated order sets in seconds rather than days or weeks.

   Doctor Peter Chang, MD, Chief Medical Informatics Officer at Tampa General Hospital, and his team decided to accomplish this with the help of LogicStream Health’s analytics software.

   MEETING THE CHALLENGE

   Tampa General uses the analytics software primarily for clinical process improvement.

   With the software, staff can delve into ordering and workflow patterns and review data in near-real time. This improves lagging outcomes by implementing and managing process measure best practices.

   Multiple staff departments can also use a utilization management program in the software to track ordering and alerting trends. For example, order sets can be ranked based on use frequency and engage with clinicians to minimize variability around best practices.

   SEPSIS

   Analytics software helped Tampa General comply with sepsis protocols.

   The analytics software built a patient population based on a sepsis alert order built into the EHR. This population helps staff analyze how well clinical alerts were followed and if the correct orders were used.

   LogicStream Health software also helps staff see individual response rates to clinical alerts. This identifies those who accept and react to alerts and those who ignore them. This provides staff with information to council clinicians, refine alerts, prevent alert fatigue and minimize workflow disruption.

   ORDER SETS

   The analytics software helped Tampa General identify and eliminate outdated order sets.

   Even if an order set is published, clinical care and guidelines can certainly change over time. Tampa General uses LogicStream to review the most popular order sets and analyze the ordering patterns from those order sets.

   They are also are able to examine order sets that are not frequently used and decide if the order sets should be modified or removed from production. Currently, Tampa General is in the process of developing a review structure across all specialties to help us expediently reach our quality goals. This feat wouldn’t have been possible just a couple of years ago.

   RESULTS

   The number of test orders decreased from roughly 90 per month to 5 per month, and the C. diff rate decreased by 50 percent in one month.

   Tampa General saw a significant increase in usage of the sepsis order set and compliance with orders placed. Clinicians are also responding to alerts in a timely manner. This prevents septic patients from developing severe sepsis, creating a decline in sepsis mortality.

   LogicStream Health also helped the hospital improve quality with Clostridium difficile (C. diff). Tampa General first identified and eliminated multiple versions of the C. diff order set. This allowed them to standardize the workflow very quickly and ensure appropriate lab test utilization.

   Finally, the software supports Tampa General’s antimicrobial stewardship efforts, since clinicians no longer are ordering antibiotics for false-positive cases.

   

2. Hospitals Already Have the Key Tool Needed to Reach Zero HAIs

   October 5, 2018 2:59 pm Leave a Comment

   The Problem

   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.

   The Solution

   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.