WINSTON-SALEM, N.C. -- Wake Forest University Baptist Medical Center is one of the first health systems in America to team with The Joint Commission’s new Center for Transforming Healthcare to use systematic methods to identify and prevent breakdowns in patient care and safety. The Center’s first initiative focuses on hand hygiene, a critical step in preventing many of the health care-associated infections that annually cause nearly 100,000 deaths and cost U.S. hospitals $4 billion to $29 billion to combat.
The Joint Commission is the nation’s leading health care accrediting organization and is dedicated to ensuring and improving health care quality.
“We are proud to work with the Center to end preventable breakdowns in health care,” said Donny C. Lambeth, president and chief operating officer of North Carolina Baptist Hospital, part of the Medical Center. “As an academic medical center, it is part of our mission to improve health care quality and safety. Participating in this national collaborative with the Center for Transforming Healthcare is a great opportunity to share our innovations in improving hand hygiene compliance and to learn from others.”
The Medical Center was invited to participate because of its extensive experience in applying Six Sigma process improvement methodologies to health care issues. Six Sigma has been widely used as a quality control approach within manufacturing industries.
Along with Wake Forest Baptist, seven other hospitals are participating in the Center’s first project to make health care safer, including: Cedars-Sinai Health System, Los Angeles; Exempla Healthcare, Denver; Froedtert Hospital, Milwaukee; The Johns Hopkins Hospital and Health System, Baltimore; Memorial Hermann Health Care System, Houston; Trinity Health, Novi, Mich.; and Virtua, Marlton, N.J. The targeted solutions developed by these leaders will be shared with the more than 16,000 health care organizations accredited by The Joint Commission. The eight hospitals selected hand hygiene as the Center’s first initiative and each developed model solutions to test.
For its pilot study, Wake Forest Baptist undertook a comprehensive environmental and workflow assessment to identify and overcome barriers and challenges to hand hygiene compliance in selected intensive care and medical/surgical care units. Solutions have included strategically located hand hygiene stations, dedicated bedside equipment as opposed to shared equipment, and innovative technology to accurately monitor hand hygiene compliance.
The Medical Center is piloting a radiofrequency identification system called Real Time Location System (RTLS) that monitors hand hygiene compliance. Specially made hand hygiene dispensers are wired to track the approach of employees wearing special electronic tags on their identification badges and to record their use of the hand hygiene dispenser. Developed by Patient Care Technology Systems (PCTS), the technology also will allow for just-in-time reminder alerts as health care workers approach the patient-care threshold. Wake Forest Baptist began its pilot test of the equipment on Aug. 24. It is the first hospital to test this hardware and software for hand hygiene monitoring.
The project is led by Ron Small, vice president of quality outcomes, Drs. Werner Bischoff and Robert Sherertz, infectious disease experts, and Melody Dickerson, R.N., an expert in Six Sigma process improvement methodologies.
The Medical Center identified accurate monitoring as a key challenge as it tracked the variance in compliance data according to who was collecting the hand hygiene observations and how frequently observations were collected. Using technology to monitor compliance is a promising way to ensure accurate, round-the-clock data collection, said Small.
The Center’s work with leading hospitals and health systems to identify, measure and tackle patient safety problem areas will lead to the development and testing of targeted, long-lasting solutions. These proven and practical strategies, based on methods such as Lean Six Sigma long used by other industries, can help transform American health care into a high-reliability industry that ensures patients receive safe, quality care, said Lambeth.
“Wake Forest University Baptist Medical Center has demonstrated tremendous leadership by stepping up to reliably measure performance, identify causes and develop targeted solutions to a crucial patient safety problem facing all health care organizations,” said Mark R. Chassin, M.D., M.P.P., M.P.H., president of The Joint Commission. “Wake Forest Baptist is making a public commitment to improving patient care by using a comprehensive system - the only way to truly make a lasting difference in safety.”
Wake Forest Baptist and the Center’s other participants set out to systematically identify and solve hand hygiene problems - from faulty data that lull facilities into thinking hand-washing is occurring more frequently than it is, to soap or alcohol-based hand rubs that are inconvenient for caregivers to use, to lack of individual accountability. All used Robust Process Improvement™ tools and proven strategies such as Lean Six Sigma.
Health care-associated infections are the fourth-largest cause of death in the United States. The Centers for Disease Control and Prevention (CDC) estimates there are approximately 1.7 million new cases of infections acquired by hospital patients every year. Although numerous strategies have been developed over the years to battle these infections, studies have found that hand hygiene -- the most basic, low-cost and low-technology infection prevention and control strategy – may be overlooked by half of health care workers, according to The Joint Commission.
Targeted solutions from the Center now being tested by Wake Forest Baptist and the other health systems include making hand washing a top priority, clearly stating compliance expectations, training staff, and always washing before entering and exiting patient rooms.
For more information about The Joint Commission Center for Transforming Healthcare, the hospitals participating in its launch and their interventional programs, visit www.centerfortransforminghealthcare.org.