Christian Hospital – a 678-bed, two-division facility in north St. Louis County, Missouri – is using a zero tolerance philosophy to reduce infections in heart surgery (coronary bypass) patients. A new checklist system ensures that all of the appropriate steps in the infection prevention process are completed, and mandatory education classes keep surgical staff members up-to-date with current guidelines for care.
Christian Hospital ’s strategy is working well. A team of quality improvement experts and in-house executive champions has reduced serious heart surgery infections by 96 percent, putting the hospital significantly ahead of a benchmark established by the Centers for Disease Control and Prevention (CDC). They have also worked to ensure patients receive pre-surgery antibiotics on time 92 percent of the time. Christian Hospital is fully compliant with pre-operative skin preparation guidelines issued by the Centers for Disease Control and Prevention.
St. John’s Mercy Hospital – a 187-bed acute care rural hospital in Washington , Missouri - is using a team approach to cut surgical infections. After setting five specific goals, establishing guidelines for care that were agreed upon by all caregivers, and holding regular progress meetings, this forward-thinking hospital improved on-time antibiotic delivery to an outstanding 95 percent (December 2004). The group also appropriately discontinues antibiotics 95 percent of the time, which is well above the national average."
One of the nation’s largest Catholic hospitals, St. John’s Mercy Medical Center – a 979-bed, Level I trauma center in west St. Louis County, Missouri – is improving surgical outcomes by redesigning how it cares for patients. Working with Primaris, and later with the Institute for Healthcare Improvement (IHI), this hospital standardized processes and better designated infection prevention accountability among caregivers. Hospital management clearly communicated goals and expectations to employees, and an infection prevention committee helped staff stay focused. Peer evaluation gave the entire prevention program credibility.
Today, St. John’s Mercy Medical Center delivers pre-surgery antibiotics in line with published guidelines almost 90 percent of the time, and expects to approach 100 percent compliance in the near future. The hospital has is also successfully encouraging surgeons to use clippers, instead of razors, when removing hair at the surgical site. Shaving before surgery causes trauma to the skin from the edge of the razor. Using electric clippers causes less skin trauma and lowers the risk of surgical site infections.
For more information, contact: Andrew Shea, (800) 735-6776 x 136, ashea@moqio.sdps.org
This material was prepared by Primaris, the Medicare Quality Improvement Organization for Missouir, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy.
