SAN FRANCISCO, Feb. 23 /PRNewswire/ -- Participating in a yearlong California surgical care quality improvement collaborative learning session, Glendale Adventist Medical Center implemented techniques that resulted in fewer surgical infections and healthier patients.
Lumetra, California’s Quality Improvement Organization for Medicare, led the Surgical Infection Prevention Collaborative learning sessions.
In 2003, the 448-bed hospital began the Collaborative with a cardiac deep wound infection rate of 7%. A year later, after participating and implementing techniques learned in Lumetra’s sessions, Glendale Adventist significantly reduced their rate to 0%.
Moreover, the hospital states they have sustained the 0% infection rate in 2004 by maintaining system improvements in surgical patient care protocols implemented during the Collaborative. Significant improvements were also made in orthopedic surgeries where the surgeries between infections were nearly doubled during the Collaborative period. This significant reduction of surgical infections was attained by implementing the evidence-based practices learned at the Collaborative.
Anupam Malik, RN, MS, Quality Improvement Manager, and Thomas Hall, PharmD lead the hospital’s improvement team. Malik saw the Collaborative as a real vehicle for better patient care at the facility where about 200 cardiac surgeries and 350 hip and knee surgeries are performed annually. Describing some of the keys to her team’s success, Malik says, “Selecting the right team members, as well as having four physician champions from the Surgery and Anesthesia departments participate, was what made it so successful.”
The Collaborative focused on three infection prevention quality measures: prophylactic antibiotic selection for surgical patients; prophylactic antibiotics received within 1 hour prior to surgical incision; and prophylactic antibiotics stopped within 24 hours of surgery end time.
Glendale Adventist also made real strides in the rate of delivery of pre-operative antibiotics within 60 minutes before surgical incision. The hospital improved from a rate of 25% to an average rate of 93% after system improvements were put into place and the anesthesiologists brought consistent oversight to the antibiotic administration.
“We were really inspired by Dr. Harriet Hopf, one of the expert panel members of the Lumetra Collaborative,” said Malik, “Dr. Hopf gave us the information we needed to help our anesthesiologists take more responsibility for antibiotic delivery.”
“Feedback given to physicians on how well their cases demonstrated compliance with the measures was a great motivator for improvement,” Anupam Malik noted at the Collaborative’s Outcomes Congress in April 2004.
There was also transformational improvement in discontinuing antibiotics within 24 hours after surgery, with a performance leap from 0% to 86%. “This was achieved primarily through individual interventions with prescribing physicians until new habits were established,” said Thomas Hall, co-leader of Glendale Adventist’s Collaborative Improvement Team. “These new habits were supported by preprinted orders, nursing cooperation, and administration support,” he added.
Overall, teams from participating California hospitals improved on delivery of appropriate antibiotic administration, which is related to decreased surgical infection, an average of 10.7 percentage points across three measures in just over a year through their voluntary participation in the Lumetra Collaborative.
Glendale Adventist Medical Center is an acute care medical facility in Glendale, California.
Lumetra is California’s Medicare Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services.
Measures Baseline Final % Change Prophylactic antibiotic administration within 1 hour before surgical incision 25% 93% 68% Discontinuing antibiotics within 24 hours of surgery 0% 86% 86% Data Source: Glendale Adventist Medical Center
Lumetra
CONTACT: Diana Parker of Lumetra, +1-415-677-2122, ordlparker@caqio.sdps.org
Web site: http://www.lumetra.com/