N.J. Hospitals Achieve Significant Results in Improving Patient Safety

PRINCETON, N.J., April 30, 2013 /PRNewswire-USNewswire/ -- One year after the launch of a statewide initiative to improve healthcare quality and safety, New Jersey hospitals have achieved significant results in reducing cases of infection, pneumonia and other adverse events.

Results include a 65 percent decline in pressure ulcers, a 55.7 percent decline in patient falls that result in harm and a 45.8 percent decline in ventilator-associated pneumonia – plus additional measurable improvements in reducing several types of healthcare-associated infections.

"Based on this important work, patients in a New Jersey hospital today are far less likely to develop an infection, experience an adverse event from improper medication or develop a pressure ulcer," said Betsy Ryan, president and CEO of the New Jersey Hospital Association. "We're extremely happy with those results, but our work continues because quality improvement is a never-ending process."

NJHA's Institute for Quality and Patient Safety is leading this effort in New Jersey, which is part of a nationwide initiative called Partnership for Patients. NJHA's Institute was selected by the U.S. Centers for Medicare and Medicaid Services as one of 26 "hospital engagement networks" nationwide charged with engaging hospitals in quality improvement activities specifically targeting adverse health events that can occur during a hospital stay. The federal initiative identified 10 target topics and set two key goals: making healthcare safer by reducing preventable hospital-acquired conditions by 40 percent, and improving care transitions so that hospital readmissions would be reduced by 20 percent.

Sixty-two New Jersey hospitals joined the NJHA Quality Institute in this effort and officially began their work in January 2012. One year later, the NJHA effort has reached the national goal of 40 percent reduction in three of the quality measures (pressure ulcers, ventilator-associated pneumonia and patient falls that results in harm) and has demonstrated significant improvement in 11 of the 12 federal quality measures. Only one measure has remained unchanged – the rate of early elective deliveries – but hospitals have recently adopted significant policy changes that they expect will change that data in the near future.

Participating hospitals have achieved the following results:

• Adverse drug events declined from 11.6 percent to 7.7 percent, a reduction of 33.7 percent.
• Catheter-associated urinary tract infections declined from a rate of 2.11 per 1,000 catheter days to 1.74, a reduction of 17.8 percent.
• Central line-associated bloodstream infections declined from a rate of 1.58 per 1,000 central line days to 1.12, a reduction of 29.1 percent.
• Patient falls declined from 0.45 per 1,000 patients to 0.2, a reduction of 55.7 percent.
• Early elective deliveries remained virtually unchanged at 2.8 percent.
• Pressure ulcers declined from 4.09 percent to 1.42 percent, a reduction of 65.2 percent.
• Surgical site infections following colon surgery declined from 4.19 percent to 3.46 percent, a reduction of 17.6 percent.
• Surgical site infections following a hysterectomy declined from 1.83 percent to 1.40 percent, a reduction of 23.6 percent.
• Surgical site infections following a total knee replacement declined from 0.97 percent to 0.71 percent, a reduction of 26 percent.
• Venous thromboembolisms (blood clots) declined from 201 to 168, a reduction of 16.4 percent.
• Ventilator-associated pneumonia declined from 0.89 per 1,000 ventilator days to 0.48, a reduction of 45.8 percent.
• Hospital readmissions within 30 days declined from 21.8 percent to 20.4 percent, a reduction of 6.4 percent.

Hospitals used "tried-and-tested, evidence-based best practices" to achieve the results, said Aline Holmes, RN, director of the NJHA Institute for Quality and Patient Safety. Hospitals worked in concert with NJHA to take part in learning sessions and Webinars led by national experts and apply standard protocols and checklists for certain treatments and conditions. The effort also emphasizes sharing among participating hospitals – sharing of lessons learned and sharing of data so that hospitals can benchmark against others and chart their results.

The hospital engagement networks designated by CMS were created as two-year projects extending through the end of 2013. It's not known at this time whether CMS will officially extend the effort beyond 2013, but Holmes said the best practices and lessons learned will continue as part of hospitals' ongoing quality improvement strategies. One area where the state is looking forward to seeing the fruits of this effort is in early elective deliveries (babies born electively before 39 weeks of gestation.) Fifty-one of the 52 New Jersey hospitals that have labor and delivery units have now stopped scheduling these early elective deliveries.

"While this specific contract may end, the commitment will not," said Holmes. "Our goal – and our ongoing motivation – is delivering the best possible healthcare to our patients."

The full report, Partnership for Patients-New Jersey: 1-Year Status Update, can be found online at http://www.njha.com/media/185129/P4PHen1YrUpdate.pdf

SOURCE New Jersey Hospital Association (NJHA)