We’ve talked in the past about efforts to eliminate ICU central line infections. Anything that improves the quality of care and reduces medical errors and hospital-acquired infections is, obviously, the right thing to do. Now we know that it’s also the right thing to do for the bottom line. From a recent press release in FierceHealth: Program Reduces Infections, Saves Lives and Money:
The reduction in bloodstream infections at hospital ICUs in Michigan saved those hospitals an average of $1.1 million a year.
"We already knew that the Michigan project saved lives and reduced infections," study leader and patient safety advocate Dr. Peter J. Pronovost, director of Johns Hopkins' Armstrong Institute for Patient Safety and Quality, said in a press release. "Now we know that by preventing infections, hospitals actually save money too."
Under the Michigan program, doctors and nurses use a "cockpit-style" checklist when placing a central-line catheter. The checklist includes five basic steps from hand washing to avoiding placement in the groin area, where infection rates are higher.
The program also includes safety education; training in how to identify safety problems, implement solutions, and measure improvements; and instructions to all team members to hold each other accountable and stop procedures if patient safety is compromised.
Consumers Report looked at this issue recently. "Bottom line: Research has repeatedly shown that hospitals, even large urban ones, can dramatically reduce and even eliminate central-line infections.” So why is it that some hospitals, using the same checklists, don’t see similar results?
John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center, goes on to say:
"For the process to work, each individual has to make a commitment to perform each step each time, and have the courage to correct their colleague when they see an error has been made."
Dr. Santa hit the nail on the head. You can implement every technology and process known to medical science, but eliminating infection rates comes down to people. Here’s the problem: The traditional healthcare hiring process does nothing to assess a candidate’s willingness or ability to “perform each step, each time” and to “have the courage to correct their colleague.”
In our new healthcare world, technical ability and experience simply can no longer be the only variables in the hiring decision. Other industries improve performance, improve quality, increase safety and reduce errors through the science of selection. It’s time (it’s been time for a while) for healthcare to do the same!