By Ashley Booker The Hutchinson News firstname.lastname@example.org
Three departments at Hutchinson Regional Medical Center won awards recently for efforts that have helped reduce infections, medicine errors and patient wait times.
For about six months, two years ago, the Outpatient Infusion department began tracking the amount of infections, blood clots and blockages involved the Peripherally Inserted Central Catheter (PICC) and how often the around $300 declotting agent Activase was used to remove blockages.
The data was surprising, said registered nurse Beth Walters.
Infections from PICC, which is woven through a vein that goes from the upper arm into a vessel above the heart, and Midline catheters were reduced from 2015 to 2016 by 100 percent, blood clots were reduced by 33 percent, occlusions – a blockage inside the catheter- were reduced by 57 percent, and HRMC saved $7,702 with a 50 percent reduction of Activase usage.
In attaining this goal, the staff revamped its education and learned they were using catheters that were too big because the tourniquet used on the arms back-flowed blood, making the veins look larger than they really were.
Now, the PICC staff ultrasounds the patient’s arm and measures the veins to see which is best for the catheter. They are also using a smaller catheter.
The patients were happier, and there was less inflammation and fewer complications, Walters said.
Once the PICC nurses changed their techniques – which were about 10 years old – they saw “significant changes,” and patients were happier. They also taught the staff nurses about dressing changes and catheter maintenance.
“The lines are able to stay in longer and are being utilized longer. You don’t have as many problems with them,” said Chelsey Price, RN.
After seeing resounding success in patient care, the department entered the President’s Quality Award, an annual program that offers the top three departments a monetary award.
Much to the department’s surprise, having never entered the awards program before, it received first place. The department now has $500 to further improve their quality of service.
“When we can make patient care safer, more efficient and more effective, the patient is the winner in the long run,” said Janet Feril, director of quality who is in charge of the President’s Quality Award.
All hospital departments are involved in ongoing improvement projects, but are asked to submit projects they are either especially proud of, or feel have a significant impact on patients, Feril said.
Since the friendly competition was started in 2012, dozens of improvement projects have been completed, or are ongoing.
“Thanks to the ‘think-outside-the-box’ and visionary health care professionals that are employed here, improvement is more than an annual contest at HRHS; it is a daily responsibility,” said Ken Johnson, president and CEO of Hutchinson Regional Healthcare System.
The pharmacy was a second-place finisher, receiving $250 for its plan that resulted in fewer patient complications and saved the hospital – and patients – money.
Around four years ago, the pharmacy implemented the Sentri7 program, which is a surveillance system that looks at the patient’s hospital chart. It can see what the patient is allergic to, what medications the patient is prescribed, if doses need to be increased or decreased, if there are medication interactions, and if additional meds or supplements are needed to improve care.
In the past, pharmacists would run up to the patient’s floor and look through their chart to see if there were any issues. Now, the program does that for the 12 pharmacists, said Jaris Regier, clinical coordinator.
Every time a pharmacist questions something and takes steps beyond the distribution cycle, that is called an intervention.
“We fell like there’s a value to these interventions,” said Patrick Mowder, pharmacy director. “If we do something that avoids a medication allergy, than that could potentially keep somebody from going into anaphylaxis, having to be put in the emergency room, having to go up to ICU and having other things happen.”
In using Sentri7, the pharmacy hoped to increase the number and documentation of interventions.
Mowder wanted his staff to go from 800 interventions to 1,100 interventions per month in a year. On average, 1,128 interventions were made per month from 2014 to 2015.
Sentri7 estimates $1.3 million was saved per intervention in that time span.
Physicians are also accepting the clinical pharmacists’ suggestions by 80 percent, Mowder said.
The department plans on growing the program even more as the years progress.
The pharmacy does not plan on entering next year’s award program because it feels like having entered every year since 2012, other departments should be given a chance to shine.
Like the Outpatient Infusion department, it was Imaging Services’ first time entering the awards program.
It received $100 for a new plan that cut wait times in half for patients not staying in the hospital and decreased the inpatient stay as well.
Staff were able to cut out Same Day Care, by directly admitting the patients to the radiology department, which resulted in a quicker turnaround time.
The preparation for procedures was also cut, as Lori Bortzfield, RN, and Tristina Herl, a licensed radiology technologist, updated the list of medications that patients must stop using before going in for procedures.
Bortzfield and Herl also found their department was losing business to a Wichita vascular center and that patients weren’t as happy.
“They were able to have their procedure done and commute back in less time than it would take to get through our whole process,” Bortzfield said about the patient’s using the Wichita facility.
With the wait time now reduced, and the medication list updated, Bortzfield said they’re hoping to get some of the business back.
All three departments haven’t decided how they’ll use their award money, but that isn’t keeping those in Outpatient Infusion from brainstorming what they want to do for next year’s award program.
Walters said they’re thinking about working on decreasing the number of IV sticks in patients.
But, as Price added, that idea is subject to change.