Leading Quality and Safety
February 28, 2012
- Elective Delivery Prior to 39 Weeks ? Does Your Hospital Measure Up?
- New WSHA/Qualis Readmission Report: Get Yours
- Tackling Surgical Site Infections in Obese and Cesarean Section Patients
- Patient Education Campaign Centers on Stroke
- Eligibility Criteria for Comprehensive Stroke Center Advanced Certification
- New Toolkit Provides Guidance on AHRQ Quality Indicators
- Upcoming Events
Elective Delivery Prior to 39 Weeks ? Does Your Hospital Measure Up?
This week, the Centers for Medicare & Medicaid Services will be challenging hospitals to reduce their elective deliveries prior to 39 weeks to below five percent. Many hospitals in Washington have already achieved this rate. Has your organization lowered its rate below five percent? If you need assistance or would like to know your rate, contact Carol Wagner at carolw@wsha.org or (206) 577-1831. (Carol Wagner, carolw@wsha.org)
New WSHA/Qualis Readmission Report: Get Yours
The Washington State Hospital Association (WSHA) has teamed up with Qualis Health to provide hospital-specific reports on readmissions. These reports are based on requests from hospitals and best practices from across the nation.
This collaboration between WSHA and Qualis Health allows information from two different data sets to be combined into one report providing a more comprehensive picture. Reports feature readmissions from all payors regardless of the hospital the patient is readmitted to and Medicare readmissions, which are by far the largest number of readmissions of any payor. There is trended information along with benchmark information. Details include how soon patients return to your hospital when readmitted, information on specific disease conditions, and readmission rate trends over time.
The reports were recently released to hospital quality leaders. We hope that the report is helpful in focusing your hospital’s readmission reduction activities. If you have questions about the report, or to receive a copy, please contact Ken Rudberg at WSHA (kenr@wsha.org) or Steve Durbin at Qualis (steved@qualishealth.org). (Ken Rudberg, kenr@wsha.org)
Tackling Surgical Site Infections in Obese and Cesarean Section Patients
In response to requests from quality leaders, the Patient Safety Program is focusing on best practices to prevent infection in obese and C-section patients. C-sections are the most common surgical procedure in the United States. The risk factors for surgical site infections for C-section patients are similar to those for all surgical site infections: obesity, diabetes, pre-existing infections, poor nutrition, smoking, and other co-morbidities. The location of the surgical wound and the increased body mass index of many patients today add to the risk of infections. Fortunately, there are a number of interventions that lower infection rates in these patients:
• Pre-surgery site preparation. Using Chlorhexidine to clean the surgical site. (As too much Chlorhexidine can result in skin breakdown, use either in a bath or immediately before surgery.)
• Drapes. Carefully removing surgical drapes to ensure the skin is not compromised.
• In-hospital wound care. Keeping the incision covered in the hospital and using negative pressure to bolster wounds on high-risk patients.
• Leaving staples intact. Allow more time for healing by waiting seven days to remove staples during a post-op follow-up visit rather than upon discharge.
• Appropriate removal of staples.
• Post-op patient education. Ensuring patients know how to care for their wounds and identify the signs and symptoms of infection.
• Don’t place unnecessary urinary catheter. Some hospitals are preventing complications by not routinely placing urinary catheters during C-sections.
WSHA is developing an info sheet outlining these and other best practices. Look for an announcement about their availability in a future issue of this Patient Safety Newsletter. (Carol Wagner, carolw@wsha.org)
Patient Education Campaign Centers on Stroke
Hospitals have a new resource for educating patients about stroke. The Joint Commission recently released Speak Up™: “What you should know about stroke.”
The materials cover information about the early signs of stroke, stroke risk factors, what to do if you are at increased risk for stroke, what happens after a stroke, and what to expect during recovery. The campaign provides helpful tips and encourages people to take action to improve their health. Speak Up materials are available in English and Spanish on The Joint Commission website.
The campaign was developed in collaboration with the American Academy of Neurology, American Association of Neuroscience Nurses, American Heart Association/American Stroke Association, National Stroke Association and NIH/National Institute of Neurological Disorders and Stroke. (Carol Wagner, carolw@wsha.org)
Eligibility Criteria for Comprehensive Stroke Center Advanced Certification
Eligibility criteria for The Joint Commission’s new Disease-Specific Care Advanced Certification Program for Comprehensive Stroke Centers (CSC) is now available on The Joint Commission website. The requirements are rigorous and require additional technology and resources when compared to Advanced Certification for Primary Stroke Centers. All standards and requirements for Primary Stroke Center certification are incorporated into the CSC requirements. Organizations seeking advanced certification as a CSC must meet all of the general eligibility requirements for Disease-Specific Care certification, as well as requirements for: volume of cases, advanced imaging capabilities, post hospital care coordination for patients, dedicated neuro-intensive care unit (ICU) beds for complex stroke patients, peer review process, participation in stroke research, and performance measures. (Carol Wagner, carolw@wsha.org)
New Toolkit Provides Guidance on AHRQ Quality Indicators™
The Agency for Healthcare Research and Quality (AHRQ) recently released a new toolkit to help hospitals utilize quality indicators to improve quality and patient safety. The kit is available to all hospitals and health care systems free of charge. The toolkit focuses on the 17 Patient Safety Indicators (PSIs) and the 28 Inpatient Quality Indicators (IQIs). Included are strategies to help set priorities and plan for performance improvements on the QIs, implement improvement strategies, and sustain improvements achieved. (Carol Wagner, carolw@wsha.org)
Upcoming Events:
Web Conference: Partnership for Patients Overview
Tuesday, March 6, 2012
11:00 a.m. – 12:00 p.m.
(Note: This upcoming March 6 conference is a repeat of the web conference previously held on February 24.)
(*) Safe Table Web Conference – Eliminating Hospital Acquired Infections Patient Safety Practices
Topic: CAUTI, Central Line
Thursday, March 15, 2012
9:00 – 10:00 a.m.
(*) Washington State Hospital Association Safe Tables are available exclusively to WSHA member hospitals. A full list of 2012 Safe Table events is posted on the WSHA website. For more information or to register for Safe Table events, please contact Janet Van Dyke at janetv@wsha.org or (206) 577-1839.
Washington State Hospital Association
300 Elliott Avenue West, Suite 300
Seattle, WA 98119-4118
Phone: (206) 577-1839, Fax: (206) 577-1936, Website: www.wsha.org
Send questions and comments to: Carol Wagner
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