The Healthcare Collaboratory

Cheryl Clark, for HealthLeaders Media , October 15, 2012
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It's not just big systems that are getting into the sharing mode. A dozen smaller hospitals in the California Central Valley are sharing practices to reduce infections.

For example, 202-licensed-bed Dameron Hospital in Stockton learned from the Patient Safety First collaborative how to tackle inpatient sepsis mortality rates of 25% in 2009, higher than the state average, says chief nursing officer Janine Hawkins, MBA, RN. In 2011, sepsis mortality was down to 16%, below the state average.

Patient Safety First is a three-year, $6 million effort that links hospitals throughout the state of California in a coordinated effort to improve patient safety through the sharing and implementation of best practices to eliminate healthcare-acquired infections. It was launched in 2010 by Anthem Blue Cross, California's three regional hospital associations, and the National Health Foundation.

The game-changing strategy was to get earlier recognition of sepsis symptoms and get physicians to insert central venous lines to get antibiotics into patients as soon as possible.

"One of our nurse managers developed the 'gold watch protocol,' " which uses a digital clock as a visual cue. As soon as a septic patient is identified, a time-sensitive series of events occur, drawing laboratory tests, conducting a thorough physical exam and appropriate fluid resuscitation, initiating antibiotics, and admitting the patient to intensive care. "Things have to happen quickly," she says. By having that clock hanging from the IV pole, everyone knows what time it is.

"We created a sense of urgency and developed a protocol that has become part of our daily operations," Hawkins says.

Weinstein, sees a "groundswell of acceptance that the systems need to do better," a kind of revolution to change the direction of "Healthcare Airlines" that is more important than the new law's expanded coverage. "I'm all for everybody being insured, but that doesn't mean you're going to have better healthcare. It's only if our systems change will that happen."


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This article appears in the October 2012 issue of HealthLeaders magazine.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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