CHI St. Alexius Health Devils Lake Hospital recently received the Zero Harm Award for achieving and maintaining the requirements of zero harm in reducing falls and Catheter-Associated Urinary Tract Infections (CAUTIs) for 12 consecutive months (October 2016-September 2017). Reducing falls and CAUTIs are two of the most challenging harm events among North Dakota hospitals. The recognition was presented by Quality Health Associates of North Dakota (QHA), the subcontractor for the Health Research and Educational Trust (HRET) Hospital Improvement Innovation Network (HIIN), for the state of North Dakota.
A key component to making patient care safer is tracking progress towards improvement using clinical data. CHI St. Alexius Health Devils Lake Hospital submitted data to the HRET Comprehensive Data System (CDS). This mechanism allowed the study of data across time using run charts to determine the effect of improvement strategies implemented at reducing patient harm.
Patient falls, an unplanned descent to the floor that results with or without injury to the patient, affect upward of 1,000,000 patients each year nationally and ranks among the most frequently reported incidents in hospitals and other health care facilities (AHRQ, 2013). Among adults aged 65 or greater, falls are the leading cause of injury-related death, the most common cause of non-fatal injuries and the leading cause of hospital admissions for trauma (CDC, 2015). Fall risk and the associated injury and cost are challenges within health care facilities and in the community. A patient fall can increase the length of stay, increase health care utilization, increase costs and result in poorer health outcomes.
A urinary tract infection occurs when microorganisms enter the urinary tract and cause infection. The infection is considered catheter-associated if an indwelling catheter has been in place for greater than two days on the infection date (CDC, 2015). Twelve to sixteen percent of adult inpatients will have a urinary catheter at some time during their hospital stay (Weinstein et al., 1999). CAUTI complications can cause discomfort in the patient and increase hospital length of stay, health care costs and mortality (Saint, 2000). The direct costs associated with CAUTI range from $749 to $1,007 per patient (Scott, 2009).
Team members collaborated to focus on evidence-based strategies to make care and the hospital environment safer for their patients by implementing interventions that reduced falls and CAUTIs. They tracked these interventions over time to determine their effectiveness. Data will continue to be monitored on an ongoing basis to assure these interventions remain effective with modifications made as needed. This achievement clearly demonstrates the dedication of the entire healthcare team and commitment to quality patient care and safety at CHI St. Alexius Health Devils Lake Hospital.
The Zero Harm Award is based on the 5th Century Hippocratic Oath committing the medical community to the goal of Do No Harm. In today’s healthcare environment, commitment of the entire medical team is required to achieve this goal. QHA will announce additional awards in 2018.
The HRET HIIN is the largest HIIN with over 1,600 participating hospitals, 34 state hospital associations, 6 QIN-QIOs and more. The HRET HIIN is pursuing the ambitious goals of reducing all-cause inpatient harm by 20 percent and readmissions by 12 percent by 2018.
The analyses upon which this publication is based were performed under Contract Number HHSM-500-2016-00067C, entitled Hospital Improvement and Innovation Network (HIIN), sponsored by the Centers for Medicare & Medicaid Services, Department of Health and Human Services.