Wednesday, March 09, 2011

#hcct Quality of Care in American Hospitals - Sepsis A secret epidemic? 200k die each year

This morning I am attending a briefing by the Partnership for Quality Care (PQC) who are releasing the National Survey Results on Quality of Care in American Hospitals. 

At the Institute for Federal Health Care Roundtable I attended on Friday this was one issue that was raised. How can consumers gain insight in to the quality of the service they are receiving, or plan to use. I will be interested to see how this survey data will be kept current. 

and more importantly, how it will be made accessible so that web sites and developers can integrate and analyze the data, incorporating it with other information to help consumers make more informed decisions.

- 2M people/Yr acquire an infection while in hospital. Many infections are preventable.
- Sepsis is #1 cause of death in US Hospitals. More than Cancer, Heart disease and stroke combined. 
- Sepsis causes twice the number of deaths than does cancer.

George Halvorson - CEO Kaiser Permanente introduced the session and pointed out the following:

The death toll is the equivalent of two 747's crashing every day. At least 40% of infection related deaths are preventable.

The study that was undertaken by PQC gauges Americans concerns about Patient safety in Hospitals.

Mary Kay Henry - Founder of PQC: 

Employers are thinking about how to do more with less. PQC is thinking about how to innovate and improve care delivery in order to bend the cost curve.

Starting a national conversation about improving care delivery. We need to change the culture in health care to improve safety for health workers and patients. 

Joel Benenson - Founder Benenson Strategy Group: Covering the survey results.

- Telephone survey (landline and mobile) 1,000 people in January 2011. Margin of error +/- 3%
- Capture impressions of quality of care in hospitals for patients.
- People see care as adequate and not exceptional in hospitals.
- Hospitals make mistakes that can be prevented

"Americans doubt that we have the best care in the world" 
56% of people rate quality of health care in America as fair/poor. in hospitals, 43% fair/poor.

Top 2 concerns:
1. Sepsis (Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria.)
2. Hospital Acquired Infections (HAI)

Other issues of lower concern:
- Acute Childhood Asthma
- Hospital Readmissions

78% described HAI as a serious problem.

Sepsis is not a well known issue. 

83% of people believe it should be a top priority once they understood the issues and implications.

Catching Sepsis early is critical. Fast track blood tests and use consistent procedures.

Dennis Rivera - Secretary of PQC:

What is PQC trying to achieve with this survey: 200,000 die from Hospital Acquired Infections.

Justine Carr - Chief Medical Officer - Steward Health Care : 
Largest network of community hospitals in MA.

Talking about solutions for HAI:
- Steward has cut HAI's by 50%.
- Nearly eliminated infections from devices.
- Cut infections after surgery by 75%

How - Team work, change culture. Universal accountability. A culture of safety. Committed to the challenge from board level down. Engaged teams at all levels. 

Simple things like washing your hands before and after attending a patient works.

Shine a light on the data. 

A Report - Days since last harm event. An event triggers a crash analysis. 
Goal is to eliminate HAI by 2014.

George Halvorson - This is not complex. This is basic functionality delivered in a consistent manner. 

Jed Weissberg - Kaiser Permanente:

Talking about Sepsis prevention.
- Look for signs at ER admission. 
- Order the blood tests and get results quickly.
- Early intervention can be very effective.

Sepsis is the cause of 25% of hospital deaths. 11 times any other cause of death in hospitals.

Sepsis Alert Teams have cut Sepsis deaths by 40% in Kaiser hospitals in California. (20 hospitals - equates to approximately 1,100 lives saved)

George Halvorson: Treating Sepsis slowly drives up cost. Aggressive action cuts costs.

Culture has to change from "Infections happen, oh well" to "Infections are not supposed to happen."  We don't accept that airplane crashes are a given. We assume they are avoidable. We analyze failures and fix processes to avoid future events.

Computerization of data will enable analysis.  

[@ekivemark:] When will patients have access to this information and analysis?

Steward Health Care: Reduced mortality by 15% or 279 lives saved.

Success demands that hospital systems empower their teams to own the challenge of eliminating Hospital Acquired Infections.
Accountable Care changes hospitals from a silo view.  Accountable Care has to put the patient at the center.

[@ekivemark:] Data is a true anti-bacterial solution in fighting Hospital Acquired Infections. Patients/Consumers need visibility for informed decisions.

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