Using Dynamite to Blow Up Infections
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This article appears in the January/February 2013 issue of HealthLeaders magazine.
It isn't every day top health officials in the Obama administration and two national professional societies host an hour-long national webinar to praise your hospital for reducing central line-associated bloodstream infections in its intensive care units, and even send a U.S. Department of Health and Human Services video team in for two days to chronicle the steps you took to achieve success. It's also not every day all this happens after embarrassing data showed your hospital had among the worst CLABSI rates in the state, and that the committee you had charged to deal with all of this had failed.
With changes in your culture and practice, even while facing financial instability, your hospital manages to reverse this surprising and humiliating distinction and becomes a national hero all hospitals are advised to emulate.
It sounds too good to be true. But that's what happened to 511-licensed-bed Hospital of Saint Raphael in New Haven, Conn., which at about the same time in September 2012 merged to become the Saint Raphael campus of 1,519-licensed-bed Yale New Haven Hospital.
"I said, 'We are going to blow up the committee and put a stick of dynamite under this. We are going to start again,' " recalls Alan Kliger, MD, vice president and chief medical officer for the former hospital and now Yale New Haven Health System's vice president and chief quality officer. After he realized how comparatively poor Saint Raphael's rates really were, "we pledged that we would do whatever is necessary to get to zero infections," he says.
HHS, the Association for Professionals in Infection Control and Epidemiology, and the Society for Healthcare Epidemiology of America heard about the success and lauded YNHH Saint Raphael Campus with a first-of-its kind Partnership in Prevention award for "the greatest sustainable improvement in eliminating healthcare-associated infections." Kliger's teams had bested 40 other applicants across the country.
During a public webinar Oct. 15, Howard Koh, MD, HHS assistant secretary for health, called the award "historic" because "reducing healthcare-associated infections is so critically important. We know that HAIs affect not only one in 20 hospitalized patients, but also many more in ambulatory and long-term care settings."
"We must broaden our healthcare system from one focused on treatment, sometimes delivered late, to a system that also is focused on prevention, delivered as early as possible," Koh said, adding that reaching the goal, "involves changing entrenched behaviors for busy professionals and large complex institutions such as hospitals."
Three other hospitals received an honorable mention for their efforts: Denver Health Medical Center; Mayo Clinic Florida in Jacksonville, Fla.; and Shore Health System in Easton, Md.
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