From the July 2012 issue of HealthCare Business News magazine
Once alerted, we monitor the case to ensure evaluation and treatment is prompt. For ICU patients, we can review the acuity score of how sick they are — which helps us determine whether to intervene in the patient’s treatment. If we don’t see action taken, one of the team members proceeds to the ICU or ED with complete knowledge of the patient’s status and what steps have been missed. You only have to do that once to change behavior. We advise clinicians to “believe in the lactate,” not the patient’s appearance.
The alerts for elevated lactate values have enabled us to accelerate treatment. We’ve achieved a sustained 74-minute faster start to antibiotic administration. From October 2009 to December 2011, our hospital has saved 130 patients suffering from severe sepsis. We’ve also reduced ventilator days and length of stay in the ICU. By addressing sepsis now, we are prepared for the future negative impact on reimbursement for hospital-acquired conditions by Medicare and some health plans.
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Through this project, we learned that clinicians will change their behavior if they are involved in the problem-solving process. Just provide them with simple, clinically appropriate tools, show them their data, and demonstrate how the protocol has made their care more effective and safer. Using this standard protocol has enabled us to reduce care variation and improve outcomes.
Our care team remains excited about our progress in this area, and we look forward to achieving even greater improvements in the sepsis care that we offer to the PRMC community.
About the author:
Chris Snyder, D.O., currently serves as the chief medical information officer (CMIO) and as a hospitalist at Peninsula Regional Medical Center (PRMC). Over the last decade, he has worked in utilization and performance improvement at PRMC. He specializes in clinical data mining and physician engagement using evidence-based educational and communication tools. PRMC is ranked by the independent health care ratings organization, HealthGrades in the top 5 percent of hospitals nationwide for quality.
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