Bundled Intervention, Continuous Improvement Credited for Reducing HAIs at Mercy Health in Muskegon
When patients come in to the hospital for treatment, our goal is to make sure that they’re better off after they leave. One way we do this is by taking precautions to reduce their risk of developing a Hospital-Acquired Infection (HAI).
Two dedicated teams in Muskegon – the Infection Prevention and Control team, along with the newly-formed Antibiotic Stewardship Committee, are spearheading efforts to reduce HAI rates – a Strategic Aim toward People Centered Care for both Mercy Health and Trinity Health. Led by Bruce Olson, MD, medical director of Infectious Disease and associate medical director of Quality at Mercy Health Muskegon, their primary goal is to protect patients, colleagues and the public from developing an HAI.
According to the Centers for Disease Control, HAIs are infections that patients can contract while receiving medical treatment in a health care facility. While they’re a major threat to patient safety, most HAIs are preventable through proactive measures.
“A lot of people have heard about Hospital-Acquired Infections, and that the majority of the time, they’re preventable. That is what we spend the most of our efforts focused on,” said Dr. Olson.
It’s not an easy task, though. Consider the fact that for clinical staff, trying to minimize the risk of developing an infection while in the hospital is like trying to dry yourself off with a wet towel. They are continually putting in catheters, central lines – or even hooking patients up to ventilators – all in an environment where inherently everyone around them is ill. The risk for exposure to an infection is there, but with Dr. Olson’s teams at work, our hospital system has been able to significantly reduce exposure to HAIs through an extremely proactive approach.
Proactively Preventative – The Infection Prevention & Control Team
There are six major categories of infection prevention:
- Communicable infection, such as influenza (spread by coughing or sneezing)
- Infections with extremely-resistant bacteria
- Infections related to surgery
- Device-related infections (bladder catheters, intravenous catheters, ventilators)
- Clostridium Difficile infection (C. Diff)
- Methicillin-Resistant Staphylococcus Aureus (MRSA) infection
To maximize the ability to identify risk and prevent infection in the hospital environment, the IPC team is made up of specialty-trained nurses, physicians and data analysts who have a continuous improvement mindset and are always monitoring their progress.
“We have a scorecard from Trinity Health and the Centers for Disease Control that tells us how we’re doing compared to other hospitals,” said Dr. Olson. “Right now, we’re doing quite well. We have an HAI rate that is currently about half that of most hospitals.”
Debbie Eisen, BSN RN, manager, Accreditation, Patient Safety and Infection Control, helps lead the group while using kata and teamwork to maintain the success of HAI reduction.
“The thing I am most proud of regarding the HAI reduction is how the departments from nursing, pharmacy, environmental services, lab and medical staff have collaborated to reduce the hospital-acquired infections at Mercy Health Muskegon,” said Eisen. The implementation of learning from defects and kata in 2017, along with multi-disciplinary communication and engagement have been instrumental in the overall reduction.”
Specifically, their team uses bundled interventions that are known to reduce risk and create a culture of safety.
For example, “If we put an IV in a patient, first – we want to make sure it’s necessary. Once the IV is no longer necessary, we get it out as soon as possible. We always want to make sure the IVs are put in using appropriate technique, and that they’re managed on a daily basis – all in a way that minimizes risk to the patient,” said Olson.
The team approach to process, along with the outcomes the IPC group is trying to avoid are what drive their efficiencies.
“Our efforts are facilitated by lean. We’re continually giving measurement and feedback to those involved,” said Dr. Olson.
The Antibiotic Stewardship Committee – Working in Partnership to Reduce Risk
Operating in tandem with the IPC group, the Antibiotic Stewardship Committee, led by Todd Capron, PharmD, has identified how the excessive use of antibiotics can cause increased resistance, which prolongs recovery and creates more risk for the spread of disease.
“We want to preserve antibiotics’ effectiveness for our patients,” said Olson.
The team has established establish guidelines for appropriate use of antibiotics in the hospital. They’ve created programs for reassessment of each patient, and modify the treatment if necessary. The ASC’s current focus is on the inpatient population – making sure to stop antibiotics if they’re no longer needed, and help identify duration of treatment and dosing. All to more effectively use these drugs to get the maximum benefit with the least amount of risk.
“These two groups are operating under the same principles, just targeting different areas, looking at process, measuring outcomes, and providing feedback – with a constant focus on continuous improvement,” said Olson. “We’re always trying to improve what we do. What was best at one time, may no longer be the most effective strategy to prevent infections.”
Debbie Eisen added, “I am excited to see what will happen in 2018 with the new Antibiotic Stewardship Committee and its alignment with Infection Prevention & Control and HAI reduction. I think Mercy Health will be the organization that other Regional Health Ministries within Trinity Health look to as a best practice.”
For more information on Mercy Health’s Infectious Disease prevention and specialists, please visit their website.