Saving Lives by Advancing Quality Initiatives
SAVING LIVES, IMPROVING DIAGNOSTICS AND PATIENT CARE BY ADVANCING QUALITY INITIATIVES
Quantifiable improvements lead to enhanced patient care at Central DuPage Hospital
Winfield, Ill., May 19, 2005 -- Programs that measure and enhance quality standards have long been a fixture of corporate policy. Creating and tracking quality initiatives within the health-care sector, however, has only recently become reality.
“Scoring the hospital’s technology for recording vital patient statistics is a relatively simple yet important area for measurement; tracking the speed of emergency treatment or rating the compassion of nursing care is more challenging,” explains Kenneth Heaps, MD, vice president of Medical Affairs, Central DuPage Hospital (CDH), an early adopter of hospital quality initiatives that include:
Intensive Care Unit (ICU), Project Impact: A significant reduction in mortality rates and length of patients’ stays were achieved in this initiative. Results were impressive: in just one year, the lengths of patient stay in the CDH ICU decreased 34 percent, from 3.2 days to 2.1 days; and average time on life support plummeted more than 50 percent. According to project leader, Jeffrey Huml, MD, ICU medical director, most significant was the improvement in risk-adjusted mortality rates (the statistical probability of who will live or die based on patients’ physiology and health status)—13.9 patients per 100 at high risk of mortality, lived, and there was a better quality of life for those who did survive. Dr. Huml attributed the improvements to a cultural change in the ICU that abolished the unit’s hierarchy; implementation of daily multidisciplinary rounds, involving the nurse, charge nurse, respiratory therapist, pharmacist and physician; and a data collection system that uses a computerized scoring system of patient physiology to provide practitioners with a statistical sense of which patients are most fragile.
CDH’s accreditation as a Chest Pain Center: one of only three in the state, this diagnostic center helps physicians identify the early stages of a heart attack, which might otherwise go undiagnosed. In one year, implantation of a Chest Pain Center in an Emergency Department has been shown to reduce mortality rates from myocardial infarctions by 37 percent*. Through specific processes and screenings, the center enhances diagnosis and treatment of patients who come to the Emergency Room with non-specific chest pain. “It’s at this stage when treatments are most effect effective, so it’s critical that they be monitored extensively and diagnosed quickly,” said Joseph Boyle, DO, Chest Pain Center Director.
More than 1,000 patients have been seen in the nine-bed observation center since its opening last summer, and the specialized approach has enabled physicians to reduce time to treatment and ensure that a patient is neither sent home too early nor needlessly admitted. “In many cases, it’s difficult for patients to differentiate between an acid reflux attack or a coronary, particularly women, since they often don’t experience the classic symptoms of a heart attack, but report general illness, fatigue and indigestion,” explained Dr. Boyle. “Our Chest Pain Center staff is specifically trained to recognize early, sometimes atypical symptoms, and treat them quickly.”
Earlier this year, CDH joined the Institute for Healthcare Improvement’s first-ever campaign to save 100,000 lives by implementing proven health-care improvement techniques. A number of changes aimed at raising quality will be implemented by CDH, including:
- Prevent Ventilator-Associated Pneumonia: Includes a series of interdependent steps that have been shown to dramatically reduce mortality and length of stay in the Intensive Care Unit.
- Deliver Evidence-Based Care for Heart Attacks: Includes early administration of aspirin and beta-blockers, key measures that prevent patient death from acute myocardial infarction.
- Prevent Central Line Infections: Includes a series of steps known within health care as the “Central Line Bundle” to prevent infections in this type of intravenous tube.
- Deploy Rapid Response Teams: Any staff member, regardless of chain of command, is empowered to call on these specialty teams to provide extra care to a patient at the first sign of significant change in condition. “The goal is to prevent a patient from coding (experiencing an emergency), and use of this approach has proven to reduce mortality rates significantly,” said Lawrence Verfurth, DO, a CDH Hospitalist.
- Prevent Surgical Site Infections: Includes delivering appropriate antibiotics before, during and after surgery, and clipping instead of shaving hair at the surgical site.
- Prevent Adverse Drug Events: Requires that a list of all of patient’s medications be compiled to ensure that patient is given the right medications and correct dosages throughout the continuum of care at the hospital and post-discharge.
The 100,000 Lives Campaign, endorsed by the American Medical Association, the Centers for Medicare & Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), among other noteworthy health-care organizations, aims to enlist more than 1600 hospitals across the country to reach its life-saving goal by year-end.
“At CDH, the delivery of high quality, compassionate healthcare is our primary goal and our responsibility to the community,” said Dr. Heaps. “Changing our own culture and re-vamping our procedures can be uncomfortable and challenging. However, by designing measurable processes to ensure that our care is the best it can possibly be, we are improving patient outcomes, enhancing our patients’ and employees’ experience and improving hospital efficiencies.”
About Central DuPage Hospital
Central DuPage Hospital is a nationally recognized 361-bed facility located in Winfield, Illinois, a suburb of Chicago. The hospital is a leading center for surgical innovations and was one of the first institutions in the nation to offer minimally invasive heart surgery, as well as a new procedure for back surgeries that uses bio-engineered bone protein.
Central DuPage Hospital is part of Central DuPage Health, a network including convenient care centers, occupational health services, and a full range of options for senior living, home health and hospice care. For additional information, please visit www.cdh.org.