Why refocus? Consider this: hospitals are starting out in the red as soon as a patient is registered due to health care-acquired infection (HAI) costs.
Based on the cost data from extensive research by Lynn White, M.D., hospitals are looking at a surcharge of $1,100 per patient before they even get to their room. Nearly 1.7 million HAIs occur annually in acute-care hospitals, resulting in tens of thousands of patient deaths and costing billions of dollars to the U.S. health care system. The total direct, indirect and nonmedical social costs of HAIs are estimated at around $96 billion to $147 billion annually, due to the loss of work, legal costs and other patient factors.
Additionally, hospitals with poor HAI scores relative to their peers also suffer from a CMS penalty of 1 percent of reimbursement being withheld. Since most HAIs require patient readmission, hospitals can also be penalized an additional 1 percent. If hospitals receive a poor patient score, then it is 1 percent more. This year each of those penalties increase to 2 percent and will continue to increase to 3 percent in 2017. The government knows that the fastest route to reducing the billions of dollars lost on HAIs is to get serious on penalizing hospitals that are not improving outcomes.
The vast majority of economic and cost analyses of HAIs focus primarily on direct medical costs, as these costs directly impact hospital finances. However, due to the large number of deaths, it is time to get everyone in the building involved in making the hospital safer for your patients. Private industry gets it. As an environmental specialist, I was recently investigating a problematic odor in the data center at a major car manufacturing plant.
Before I could enter the plant I had to show proof that I had participated in their specific safety program which is required annually. What makes it more interesting is the value of one of this facility’s cars is the same average cost of one patient’s HAI at most hospitals. The manufacturer values its product and protects it by making sure everyone knows the rules of working in their plant. Yet, hospitals allow many people to work in their facilities that know nothing about the dangers their work can create for a patient.
Just like a great football coach would not send his team out on the field with only a quarter of them knowing the play — the same needs to happen in hospitals. If the play is to reduce costly HAIs and improve quality outcomes, then more than a handful of people need to truly understand the importance of HAI prevention techniques in today’s health care environment.
Following these steps can refocus everyone on what is most important:
- Appoint a top-level administrator to shepherd the project.
- Explain why health care facility personnel need to follow government-regulated guidelines.
- Ask each department for HAI and quality improvement ideas from their employees.
- Train outside vendors on what HAIs are and how to avoid causing them.
- Share ideas between departments and vote on the top three ideas to get started. Too often, administrators look to department directors for solutions when employees are the ones with the answers.
For example, at one hospital, my team repurposed the security staff with infection prevention education. Once the security staff understood how HAIs occur and why it is important to their own employment, the newly educated security officers roamed the facility with additional authority. Armed with knowledge and increased awareness, the guards can stop contractors who are not following infection prevention procedures, such as dust reduction protocols, and report dirty areas to the environmental services staff. The officers felt more important. They were given more authority for the well-being of the patient and have a voice in operations. Not only did attitudes improve but quality also bumped up.
One facility manager told me that every morning he visits the maternity ward to look through the viewing window at all the newborns. This gives him purpose for his day since he knows the work his team performs can provide a quality environment for everyone, including the babies, in his hospital. The Cleveland Clinic developed an Empathy series of videos that aid in educating staff on looking at the big picture and not just their own personal issues. Explaining that others are counting on them can be enough to change the attitude and performance of many on your team.
“This article was published in the July 2016 issue of Healthcare Business News.”