Latest Success Stories from Massachusetts Hospitals
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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Cambridge 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.
In a new report in the July 2015 edition of The Joint Commission Journal on Quality and Patient Safety, clinicians at Brigham and Women's Hospital (BWH) describe the implementation and effectiveness of a hospital-wide clinical improvement initiative for acute care patients at risk for delirium, alcohol withdrawal and suicide harm (DASH), and demonstrate its effectiveness in reducing readmission rates.
Massachusetts Hospitals are Working Hard to Ensure Patient Safety
For example, take the Massachusetts Hospital Engagement Network (MA HEN) which up to 31 hospitals in the state have participated in over the past three years and which MHA has coordinated. Under MA HEN, participating hospitals adopt new practices to help achieve the ambitious quality-and-patient-safety improvement goals of reducing all cause preventable harm by 40% and cutting readmissions by 20%. The MA HEN, which ended in December 2014, led to proven, measureable success in improving patient care by preventing 3,290 harms with an approximate cost savings of $25 million.
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.
A 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 drop beginning in 2012. The improvements may be due to the increased focus on the issue that hospitals undertook in response to Medicare readmission penalties that the federal government instituted in recent years.
In 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. Together these efforts have proven successful in reducing overall acute care hospitalization rates.
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%.
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.
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.
Across 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 readmissions. There are 102 CCTPs funded nationwide and four in Massachusetts, funded by the Centers for Medicare and Medicaid Services (CMS).
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.
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.
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.