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Quality outcome metrics, compiled for the entire organization, include readmissions, discharge/disposition delays, delays in service/turnaround time, patient satisfaction, and inappropriate admissions.
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Amid the successes in sharps safety in hospitals in the 21st century, there is one glaring gap: the operating room. Sharps injuries there remain as much of a problem as they were in 2000, when the Needlestick Safety and Prevention Act was signed into law.
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A recent federal report that included the highly publicized finding that some 15,000 Medicare patients die every month due to adverse events and hospital-acquired conditions (HAC) may ratchet up pressure on hospitals to prevent infections, which represented some 15% of the HACs.
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Spectrum Health, based in Grand Rapids, MI, has introduced a successful patient safety program called "Condition Concern" that its proponents say offers a unique approach to patient and family involvement in expressing concerns they have about care. The program was described in a recent article in the Journal of Nursing Care Quality.
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Thirteen rural hospitals in the state of New Hampshire decided several years ago to pool the funding of each hospital's Small Rural Hospital Improvement Grant Program (SHIP) funds to create a network for a QI initiative called the New Hampshire Critical Access Hospital, Quality Improvement Network (QIN).
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The first year after Piedmont Hospital in Atlanta implemented a Heart Failure Resource Center that provides care coordination for patients discharged with heart failure, the 30-day rehospitalization rate for heart failure patients in the program decreased from 4.6% to 1.6% when compared to heart failure patients treated at Piedmont and not in the program.
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WellPoint's initiatives to reduce hospital readmissions by following up with Medicare Advantage members after discharge has decreased the readmission rate and reduced skilled nursing days, according to Karen Amstutz, MD, vice president and medical director of care management for seniors and state sponsored business for the Indianapolis-headquartered health benefits company.
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By placing on-site nurse case managers in hospitals and post-acute facilities, Presbyterian Health Plan of New Mexico has saved more than $1 million in just 10 months, according to Paula Casey, MSN, RN, ONC, CCM, clinical director for inpatient and recovery services at the Albuquerque-based health plan.
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To prevent hospital admissions, gather as much information as possible about the patient's discharge needs, psycho-social needs, and support systems in the community, Cory Sevin, RN, MSN, NP, director with the Institute for Healthcare Improvement advises. Talk to family members and primary care providers who know the patient and can provide first-hand information, Sevin says.
