Latest Success Stories from Massachusetts & Rhode Island Hospitals & Home Care Alliance of MA
For other stories about hospital efforts to stem infections, falls, readmissions, and more click on the tabs under "Success Stories" in the column at left.
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Massachusetts Hospitals are Working Hard to Ensure Patient Safety
The Massachusetts Health & Hospital Association (MHA) once again, is serving a Hospital Improvement Innovation Network (HIIN), as part of the Centers for Medicare and Medicaid Services (CMS) Partnership for Patients (PfP) Campaign.
The Centers for Medicare & Medicaid Services awarded the Health Research & Educational Trust (HRET) a two-year HIIN contract (with an optional third year based on performance), to continue efforts to reduce all-cause inpatient harm by 20 percent and readmissions by 12 percent by 2018. An American Journal of Medical Quality article, written by HRET staff, explores the relationship between engagement in improvement activities and affected quality measures.
Or take MHA's participation in the Choosing Wisely Massachusetts campaign led by Massachusetts Health Quality Partners (MHQP). Hospitals and others are coming together to encourage patients to discuss with their physicians whether diagnostic imaging in the treatment of lower back pain and persistent headaches is appropriate. The goal is to help erase the long-held misconception that "more" care equals "better" care.
Massachusetts hospitals are also leading the effort against opioid addiction. Hospitals are currently adopting the recommendations from MHA's Substance Abuse Prevention and Treatment Task Force that will assist in reducing the number of opioid pain prescriptions from hospital EDs and result in a corresponding reduction in the number of opioid overdoses that are occurring in Massachusetts.
Effect of a Multidisciplinary Team Approach to Eradicate Central Line Associated Blood-Stream Infections (CLABSI)
At UMass Memorial Medical Center use of a multimodal approach to catheter care resulted in more than an 89% decrease in CLABSI over a 7-year period.
For the past two years, the Massachusetts Coalition for the Prevention of Medical Errors (the Coalition) and the Massachusetts Hospital Association (MHA) have been offering programming to support the prevention of hospital-acquired infections throughout the Bay State.Massachusetts hospitals have made infection prevention a top priority for patient safety and quality improvement; executive and clinical leadership at 100% of acute-care hospitals have signed on to participate in this initiative. The Coalition and MHA are pleased to present a sample of the infection prevention successes from Massachusetts hospitals across the state. If you are a consumer, use this guide to see what hospitals in your area are doing to prevent hospital-acquired infections. If you are a provider, look for ideas that you can incorporate into your own infection prevention efforts.
Over six consecutive months in 2013, Jordan Hospital in Plymouth has not recorded a single catheter-associated urinary tract infection (CAUTI) in its Critical Care Center - an impressive statistic that has required intensive, shift-by-shift persistence by caregiving teams throughout the hospital and a wholesale change in the hospital culture.
- Newton-Wellesley Hospital’s Bert Thurlo-Walsh, R.N., MM, CPHQ, Assoc. CQO/V.P., Patient Experience & Medical Staff Services and Dr. Janet C. Larson, Chief Quality & Experience Officer were invited to the Health Research and Educational Trust (HRET) Hospital Improvement Innovation Network (HIIN) The Journey Ahead national conference in San Diego last month to present their hospital's ...» Full ArticleIn 2013, during a period of significant institutional growth, Beth Israel Deaconess Hospital–Needham (BID–Needham) began an organization-wide effort to enhance its commitment to patient safety, employee engagement, and patient and staff satisfaction. As a result if its efforts, BID-Needham’s scores on the AHRQ Culture of Safety Survey rose to the 98th percentile rank within one year of im...» Full ArticleSouth County Hospital of Wakefield, R.I., in 2014-15 noted a spike in post-cesarean surgical site infections (SSI). An inter-professional team was established to review current practice and opportunities for improvement, and settled on a goal of “zero harm.” To meet the goal, the hospital made changes to its “Best Practice Care Bundle,” instituted provider and staff education, as well...» Full ArticleLeadership rounding at the bedside - the process where nurse leaders, administrators, and others talk directly with staff and patients about care and services - is a best practice in most hospitals, yet it comes with many challenges. It can be time consuming and difficult to standardize. When rounding is done using a pen and paper, how can care teams compile trend data in the department and across...» Full ArticleThat’s the number of central line-associated bloodstream infections (CLABSI) that Westerly Hospital in Rhode Island has experienced in both its ICU and medical/surgery units from 2015 to today. Its performance in containing catheter-associated urinary tract infections (CAUTI) is equally as remarkable; in the hospital’s ICU and med/surg units there has been just one CAUTI, in the ICU, since 201...» Full ArticleKent Hospital’s Good Catch Award is a way to demonstrate the hospital’s commitment to keeping patients, visitors and employees safe by rewarding those individuals who "speak up" to prevent harm and improve the culture of safety. The Good Catch Award creates positive incentives for providers and staff to report patient safety events. Kent Hospital’s staff strives continuously to enhance th...» Full ArticleImagine you're a newborn, contentedly relaxing in a dark and warm place, bathed in amniotic fluid, when suddenly - BAM! - you're out in the world, surrounded by strange people, who are smiling and cooing at you but who are, nonetheless, very, very strange. "It's the greatest adventure of their lives," says Cheryl McInerney, R.N., IBCLC, a lactation consultant at Cambridge Health Alliance. "And ...» Full ArticleAcross the state hospitals are uniting with community-based organizations to form tight, integrated clusters of care with the goal of reducing hospital readmissions. Focusing on high-risk Medicare patients recently discharged from hospitals, and funded through Section 3026 of the Affordable Care Act, these Community-based Care Transition Programs (CCTPs) are successfully cutting avoidable readm...» Full Article
Beth Israel Deaconess Medical Center among the first-ever awardees in the National Awards Program to Recognize Progress in Eliminating Healthcare-Associated InfectionsThe US Department of Health and Human Services has named Beth Israel Deaconess Medical Center among the first-ever awardees in the National Awards Program to Recognize Progress in Eliminating Healthcare-Associated Infections. The awards focus on central line infections and ventilator-associated pneumonia, two of the deadliest and most expensive hospital-acquired infections. Preventing hospital-...» Full Article
Beth Israel Deaconess Medical Center Wins $4.9 Million Grant for Program to Improve Patient Outcomes Within 30-Day Window of DischargeOne of only 26 national Center for Medicare and Medicaid Innovations Grants Beth Israel Deaconess Medical Center will receive $4.9 million from the highly competitive first round of Center for Medicare and Medicaid Innovation Grants, to launch a Post-Acute Care Transitions (PACT) program designed to improve patient outcomes and prevent avoidable cost in the high-risk 30-day period following acu...» Full ArticleBeverly Hospital in Massachusetts has significantly reduced the rate of patient falls on its units by implementing a comprehensive fall prevention program, WCVB Boston reports. According to a recent state report, 70 percent of serious injuries in Massachusetts hospitals were caused by falls, with older adults proving particularly vulnerable. As a result, preventing falls has become a top priori...» Full ArticleBeth Israel Deaconess Medical Center will collaborate in two additional federal innovation awards announced last week: one with Dartmouth-Hitchcock Medical Center as part of the High Value Healthcare Collaborative (HVHC) and one with Mayo Clinic. These awards were announced as part of the second and final round of Innovation Grants awarded by the federal Center for Medicare and Medicaid Innovat...» Full ArticleThree nurses at Boston Medical Center are taking a proactive rather than reactive approach to skin care. The skin team RNs - two full time and one part time - constantly emphasize the importance of assessing patients' skin from head to toe. Because ongoing documentation of pressure ulcers is necessary to ensure Medicare reimbursement, the nurses review with staff on a regular basis how to pro...» Full ArticleHospitals around the country are grappling with the issue of alarm fatigue. The concern is that the constant noise of equipment alarms on hospital inpatient floors is so overwhelming that nurses can become desensitized, thereby creating potential patient safety risks. This issue is so pervasive that the Joint Commission--the accrediting body for hospitals nationwide--is implementing a new national...» Full ArticleThe Centers for Disease Control and Prevention today announced significant gains in hospitals' efforts to prevent healthcare-associated infections in 2010. These include a 33% reduction in central line-associated bloodstream infections, 18% reduction in healthcare-associated invasive MRSA (methicillin-resistant Staphylococcus aureus), 10% reduction in surgical-site infections, and 7% reduction in ...» Full ArticleIn the past eight quarters since the end of 2007, Cooley Dickinson Hospital - a 140-bed facility in Northampton, Massachusetts - has had three quarters with zero incidents of pressure ulcers (bed sores). It's impressive because even under the best circumstances, bedsores "happen." That is, patients enter hospitals with their skin severely compromised from long illnesses. Or their treatment is s...» Full Article
Cooley Dickinson Hospital: Better-than-National Infection Rate Drops Further Following UV Room DisinfectionIn America's hospitals, approximately one in 20 patients will contract a hospital-acquired infection (HAI). At Cooley Dickinson Hospital last year, one in 129 patients got an HAI. Now, those better odds of avoiding an infection at Cooley Dickinson have improved even further, as the hospital has documented a groundbreaking 82 percent drop in one type of infection, Clostridium difficile (C. diff), a...» Full Article
Falls in hospitals happen. Recognizing the issue, the Joint Commission has stepped in to require hospitals to implement falls-reduction programs as a requirement of accreditation, and the Centers for Medicaid and Medicare Services will no longer reimburse hospitals for the cost of care that results from inpatient falls. Heywood Hospital in Gardner, Mass. - a 134 bed community hospital - has assembled a team to deal with the falls issue, which at Heywood is made even more difficult ty the presence of an in-facility geriatric psychiatric unit.»Full ArticleOver six consecutive months in 2013, Jordan Hospital in Plymouth has not recorded a single catheter-associated urinary tract infection (CAUTI) in its Critical Care Center- an impressive statistic that has required intensive, shift-by-shift persistence by caregiving teams throughout the hospital and a wholesale change in the hospital's culture. By eliminating incidences of CAUTI, a common infect...» Full ArticleThere is always a lot of talk about the power of teamwork and successful teams yet there is little talk of what actually defines a great team. This 2011 article in Advance for Nurses discusses how nurses on a med/surg floor at Lawrence General Hospital improved patient safety through making hourly "rounds with purpose"....» Full ArticleJordan Hospital in Plymouth, Mass., has undertaken an innovative strategy to deal with patient falls, which is a common problem that occurs just about everywhere that care is provided -- from hospitals to homes. People who are ill, recovering from surgery, on new medications - to name just a few of numerous reasons - often fall down, causing serious injury. It's a phenomenon that has caused all...» Full ArticleAs the Centers for Medicare & Medicaid Services (CMS) continue to provide less payment for hospital acquired pressure ulcers, increased demands are placed on nurses to reduce the number of patients who acquire these conditions. As pressure-ulcer incidence rates continue to rise, more hospitals are implementing intervention and prevention programs in order to combat pressure ulcer occurrence an...» Full ArticleFor MetroWest Medical Center, a 319-bed regional healthcare system with hospital campuses and outpatient facilities in the adjacent towns of Framingham and Natick, Mass., seven was just the right number of tactics needed to put its outpatient scores where they belonged - at the top. In fact, throughout fiscal year 2011, MetroWest's outpatient scores have consistently remained above the 96th percen...» Full ArticleCatheter Associated Urinary Tract Infections (CAUTIs) are an often preventable healthcare- associated infection (HAI) common in hospitals across the country. These infections can be a serious complication for patients, can increase the time they are hospitalized and add to the cost of care. On occasion, antibiotic treatment of CAUTIs can also pose potential health risks for the patient. PLAN: I...» Full ArticleAccording to the Institute of Medicine (IOM), "medication-related error … is one of the most common types of error, substantial numbers of individuals are affected, and it accounts for a sizable increase in health care costs."* In order to decrease the potential for medication-related errors, Newton-Wellesley Hospital launched a major patient safety initiative in 2009 - the implementation of a...» Full ArticleA program at the Norwell VNA and Hospice that targets patients with Heart Failure (HF) has proven successful in reducing hospital admissions and readmission. The Norwell model relies on two foundational elements: (1) a strong clinical commitment to chronic care management using a wide-ranging team of providers and the patient, and (2) early intervention using telehealth technology. All of No...» Full ArticleReducing falls and the injuries that arise from such falls is a major goal of Massachusetts hospitals, which report their falls data through PatientCareLink. And our hospitals are developing the best practices, innovative strategies, and measurement tools that other states are using to address the issue. In the Vol. 304, No. 17, November 3, 2010, issue of JAMA - the Journal of the American Medi...» Full ArticleThe results are in from Partners HealthCare's Medicare demonstration project that was conducted at Massachusetts General Hospital (MGH).In August, 2006, the Centers for Medicare and Medicaid (CMS) funded the MGH and the hospital's physician organization to launch the Care Management Program at MGH, one of six demonstration projects nationwide. During the three-year demonstration, the MGH develop...» Full ArticleIn 2011, MetroWest HomeCare & Hospice, in partnership with MetroWest Medical Center, initiated a strategic and evidence based effort to reduce their emergent care visits and acute care hospitalization rates. The effort was initiated with the formation in November 2011 of MetroWest's Re-Admission Intervention Strategy Council (RISC). The RISC includes representatives from management, nursi...» Full ArticleBy John C. Richmond, MD and Maureen Spencer, RN, M.Ed, CIC This article is reprinted from the August 2010 First Do No Harm newsletter produced by the Quality and Patient Safety Division of the Massachusetts Board of Registration in Medicine A post-operative infection can be a devastating complication for any patient. This is particularly true in elective orthopedic surgery, where the patient t...» Full ArticleSouthcoast Health System's well thought-out program to reduce patient "sitters" - the individuals who spend time with patients to ensure that they do not fall and injure themselves - makes sense financially for the system, but has its genesis in improving patient safety and strengthening the caregiving team."They're not just sitting there. They are now interacting with the patients" says Joyce D...» Full Article
Since its physicians began using a new Computerized Physician Order Entry (CPOE) system when prescribing drugs and after it set up a peer-review panel that assessed medication errors, Spaulding Rehabilitation Hospital - Cape Cod in Sandwich has reduced Adverse Drug Events (ADEs) by 61%.»Full Article
At Tufts Medical Center (Tufts MC) in downtown Boston, the small team that was assembled to reduce, or eliminate, CLABSI has had remarkable success. Since 2010, through a daily effort that has involved the hospital's most senior leadership, nurses at the bedside, and assistive personnel, Tufts Medical Center reduced central line-associated bloodstream infections by 80%. In some of its units, Tufts MC has had 600 and 800 CLABSI-free days.»Full ArticleA Focus on Infection Prevention Two hospitals within the UMass Memorial Health Care system each received the 2009 Betsy Lehman Patient Safety Recognition Award from the Betsy Lehman Center for Patient Safety and Medical Error Reduction, a program established under the Executive Office of Health and Human Services and housed within the Massachusetts Department of Public Health. UMass Memorial Me...» Full ArticleTool used to help engage patients in their own care. One of the biggest challenges with managing diabetes is motivating patients to take an appropriately active role in their health. To help meet this challenge, UMass Memorial Medical Center has launched a pilot program to test an innovative diabetes management "scorecard." The scorecard contains the patient's diabetes-related health infor...» Full ArticleExecutive Treatment Urged to Drive Down Infection RatesBy Jane Sherwin Culture change requires top leadership to get engaged, collaborate with staffReducing catheter-related bloodstream infections remains a challenge for many hospitals. In a recent survey by the Association for Professionals in Infection Control and Epidemiology, 40 percent of respondents said their hospitals had been targeting ...» Full ArticleAn estimated 85 percent of hospital-acquired infections are due to organisms carried on the hands of personnel. As a result, Winchester Hospital has launched a hospital-wide hand hygiene competency for all employees in an effort to save patients from avoidable harm.The competency includes reciting three opportunities for hand hygiene, communicating three infection prevention strategies (stayin...» Full ArticleLike all hospitals, Winchester Hospital has its share of preventable harm events and, like all hospitals, it is constantly striving to improve. In 2008, Winchester Hospital experienced 108 preventable harm events in five categories: serious medication errors; surgical site infections; ventilator-associated pneumonia; falls with serious injury; and central line-associated bloodstream infections. At...» Full Article
A partnership between the Winchester Hospital Joint Program, Excel Orthopedics, and Winchester Home Care, via a private health information exchange, is working on a collaborative effort to identify which patients are appropriate for each post-acute care setting. The collaboration has reduced rehabilitation stays and increased the rate of discharges to home after elective joint replacement surgery.»Full ArticleA variety of different measures all point to one inescapable fact: readmissions of Medicare patients at Massachusetts hospitals are steadily decreasing, according to a new MHA analysis. Statistics over the past decade show that Massachusetts hospitals, as well as hospitals nationwide, over the past decade at first had incremental improvements in readmissions before experiencing a significant dr...» Full ArticleThe percentage of patients admitted to a hospital with a mental health condition - either as a primary or a secondary diagnosis - is rising and often these patients experience delirium, alcohol withdrawal and suicide harm (DASH), which put them at an increased risk for higher-than-average readmission rates. In a new report in the July 2015 edition of The Joint Commission Journal on Quality and ...» Full ArticleCambridge Health Alliance (CHA) and Hallmark Health, in collaboration with Somerville Cambridge Elder Services and Mystic Valley Elder Services, are among the top performers in an innovative national pilot program to reduce hospital readmission rates. The four organizations, known collectively as the Mystic Valley Community-Based Organization, joined 71 other community-based organizations (CBOs...» Full Article