Hospitals See Rapid Progress in Reducing Infections, Other Preventable Problems

Association credits statewide improvement to federally backed initiative under Affordable Care Act

Aline Holmes, director of the NJHA Institute for Quality and Patient Safety.
New Jersey hospitals are celebrating a major drop in hospital infections and other preventable problems last year, due to a federally funded initiative that’s part of the Affordable Care Act.

The effort, led by the New Jersey Hospital Association, is aimed at improving the quality of care offered at hospitals by reducing preventable illnesses that originate in healthcare facilities. These problems are a major cause of concern at hospitals and reducing their occurrence is a goal of federal health reform.

The association has been holding face-to-face learning sessions in which doctors and nurses share their experiences in reducing the spread of infections, readmission rates, and other preventable problems.

“It’s really bringing together clinicians and focusing on what are the best practices,” said Aline Holmes, director of the NJHA Institute for Quality and Patient Safety and a registered nurse.

It took only one year for hospitals to achieve broad-based improvements, according to an association report released yesterday. The initiative, known as Partnership for Patients, was launched at the beginning of 2012 and is scheduled to continue through the end of this year.

The state saw improvements in 11 of the 12 quality categories being tracked by the federally funded initiative. The improvement in the readmission rate is particularly significant for the state. Hospitals with high levels of readmissions face financial penalties under a separate ACA program.

An NJHA affiliate is one of 26 “hospital engagement networks” across the country that is aiming to reduce the 12 preventable problems by 40 percent from 2011 to 2013.

“It was a full-court press,”. Holmes said.

Along with seeing drops in infections from colon surgeries, hysterectomies, and knee replacement surgeries, the hospitals improved in areas ranging from hospital readmissions, which fell by 6.4 percent, to pressure ulcers, which fell by 65.2 percent.

These dramatic reductions show hospitals can prevent problems like these from occurring if they focus on them and apply lessons learned from the success stories of other healthcare providers.

New Jersey hospitals have a poor track record in some of these problem areas, including readmissions, compared with hospitals in other states.

The only area where improvement didn’t occur was in early elective deliveries. However, most hospitals in the state have changed their policies to reduce these cases, which should also reduce the number of induced and caesarean births, Holmes said.

The report is a sign of progress in tackling an important issue, according to David Knowlton, president and CEO of the New Jersey Health Care Quality Institute, which has promoted efforts to reduce hospital-acquired infections.

He noted that when state officials increased public reporting of hospital-acquired infections, “the hospital association, instead of pushing back, actually embraced it.”

The one-year drop was the result of years of work focusing on these issues, according to Dr. Anthony G. Slonim, executive vice president and chief medical officer of Barnabas Health.

“What we’ve seen in a variety of other places and approaches is that teamwork really matters,” said Slonim, adding the success is a result of collaboration between hospitals, the association and the federal Centers for Medicare & Medicaid Services (CMS), which launched the initiative.

For example, the sessions drew on years of work by the association and hospitals in reducing urinary infections from catheters, by ensuring that catheters are only used when appropriate and removing them as soon as possible, Holmes said. In addition, changing the material that is applied to the skin before the line is inserted has reduced central line infections.

Holmes said it can be helpful for doctors and nurses to hear from professionals from other organizations.

“They can serve as resources so that if organizations get stuck or they’re not seeing the kind of improvement they want, it can be helpful to talk to somebody outside,” Holmes said.

Holmes expressed hope that the 62 hospitals that participated in the initiative will achieve 40 percent reductions by the end of the project.

“I do think we’ll be there,” Holmes said. “We’ve seen a lot of progress.”

She added that the rate of hospital readmissions is the most difficult to reduce.

CMS is scheduled to inform local networks like the NJHA in October whether the initiative will be extended for a third year.

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