Quality of care is constant focus
By Bobbi Mlynar (Contact)
Originally published 01:13 p.m., May 8, 2008
Updated 01:13 p.m., May 8, 2008
Quality of care is an ongoing issue — and has been for years — at Newman Regional Health, according to managers who recently made time to talk about the topic in depth.
The managers were responding to concerns about quality of care voiced by a local internal medicine physician, Jim Barnett, at a public health forum here last month.
“Patient safety is always our highest concern and the primary consideration in every decision we make in the hospital — and we have invested hundreds of thousands of dollars to do what we can do,” said Nancy LeClear, education and marketing director for Newman.
Quality of care is always an issue, the managers said.
The hospital continually measures its performance against itself and against other hospitals across the country.
“We voluntarily participate in almost every quality database there is, if it’s based on comparable and valid data,” she said.
Some of the data is federally mandated for Medicare reimbursement; other data provided is voluntary. Only about half of the country’s hospitals participate in any of the voluntary segments of the surveys.
“We voluntarily go the extra step is what I’m trying to say, collect more than we’re required to, and report more than we’re required to,” LeClear said.
Newman has instituted numerous patient safety initiatives and continues to research and develop more. They are continually updating quality initiatives from information available nationally. LeClear cited the “30 Safe-Patient Initiatives” the hospital has adopted and the national “5 Million Lives” program that focuses on 11 initiatives to improve patient care. The latter has been in place for more than three years.
“We have a task force and a team working on every single one of those 11 initiatives,” LeClear said. “… (E)very time something comes out in national recommendations, we look at those and figure out how we can apply them in our hospital and how they can be done. Many times, we are way ahead of curve on that.”
LeClear said that the hospital also has instituted rapid-response teams that can methodically assess a condition and decide a course of action.
“You have to make sure you’re doing the right thing,” LeClear said. “… When it’s your loved one, it’s an important thing, and that’s why we have to improve things for everyone. We are putting so many things into place. We have done it; we are doing it.”
Jami White, Newman’s director of infection control, employee health and workers’ compensation, said that Newman long has been in the forefront of hospitals in taking precautions to try to prevent infections in sick patients and those who have come in for surgeries.
The Center for Disease Control and Prevention in Atlanta estimates that 90 percent of all surgical-related infections are from organisms found on the patient’s own skin, White said.
Newman policy requires that patients be given the proper antibiotic 30 minutes to an hour before surgery to help prevent infections. Nurses no longer shave patients with razors prior to surgery, though in some cases, they do use a hair clipper, she said. Keeping a patient warm during surgery and maintaining the patient’s blood sugar level within a normal range also are among many preventive care protocols recommended to try to avoid infections.
Renovations at the hospital already have turned one wing into all-private rooms, and remodeling to accomplish the same result in another area is underway. White and LeClear said that Newman tries whenever possible to see that each patient is kept in a private room, to avoid germs passed while sharing a bathroom or brought in by visitors to the patients.
“If our (patient) census allows it at all, we absolutely do that,” White said.
Newman began its active surveillance system in 1999, in an effort to identify patients with resistant organisms and isolate them in private rooms. They also screen patients on re-admission, as well as others who had contact with another facility or an open wound that would be considered high-risk and require that cultures be taken.
“In 2006, the CDC (Center for Disease Control and Prevention) came out with recommendations to institute it,” she said. “We had an easy time when the recommendations came out; we were meeting every one of them.”
Nothing is too small to be overlooked as a potential source of infections. White said that use of artificial and long fingernails has been restricted for several years before the CDC recommendations to that effect.
However, despite precautions, patients do contract infections, especially if they come in with an existing infection, or have conditions that automatically increase their odds.
“For example, a 30-year-old, normal weight, did not smoke and was not diabetic, his risk would be fairly low,” White said. “A 65-year-old overweight, diabetic, who was a heavy smoker, that risk would skyrocket for infection from that surgery.
“The more we minimize our own health problems, the less our risk. So we can do a lot for ourselves in preventing infections.”
LeClear gave similar advice.
“We absolutely believe that patients have to be their own advocates for health care,” LeClear said. “This world has become too complex and complicated to rely on one nurse, on one doctor for all the answers to every situation.”
When infections occur, White said, staff members go back through the records to study every process related to the infection.
“Did we do the right thing, did we give the right antibiotic, did we do the right prep … that we followed the right process,” White explained.
The processes involve not only Newman personnel but surgeons and patients themselves.
“Because if we can learn from something and institute a better process, we want to make sure we’re doing everything we can so that the patient has the very best outcome,” she said.
The primary focus on infection intervention is on “good-hand hygiene,” White said. Alcohol-based products are available inside and outside of every patient room for staff, physicians and visitors.
“We follow to the letter CDC guidelines for prevention of central line-related bloodstream infections,” White said.
Newman policy requires that permanent IV access, inserted by physicians, is done with the proper equipment and using full sterile techniques.
“Meaning the surgeon should wear a gown and cap and use the right prep on the skin and use a drape,” White explained.
White said that while her peers in other hospitals in Kansas and Missouri were surprised that the hospital administrators would agree to all of those processes, she has not encountered resistance from the administration.
“Time after time I have met with administration to try to institute something. If it makes sense, if it’s going to make better care for our patients, I have just not had any problem,” she said. “Even if there’s hardly anybody else doing it. … Oftentimes we do it several years before it becomes a recommendation nationwide. I’m very proud of our hospital and our infection-control program.”
Comments
Post a comment
We allow registered users to post comments on this Web site. Our goal with this feature is to encourage thoughtful discussions about the news stories. Using the comment feature to make random attacks on people is not acceptable. Emporiagazette.com neither endorses nor guarantees the accuracy of any user contribution. Responsibility for what is posted or contributed to this site is the sole responsibility of each user. To learn more about our posting policies please read our User Poster Agreement Policy.
(Requires free registration.)