Efforts to reduce infections, falls and other harmful incidents at hospitals appear to be working, officials from a quality improvement initiative told members of the House Health and Human Services Committee.
The Kansas Healthcare Collaborative is an initiative launched by the Kansas Medical Society and the Kansas Hospital Association in 2009 with the aim of helping doctors and hospitals reduce so-called "hospital-acquired conditions," including:
- adverse drug reactions,
- infections from surgery and other treatments,
- bed sores,
- life-threatening blood clots,
- causes of preventable readmissions, and
- early elective deliveries.
Kendra Tinsley, the collaborative's executive director, told committee members on Monday that the initiative was relatively unusual in that it is led by medical providers.
Testimony: Quality Improvement Initiatives in Kansas
"There are probably just under 100 (initiatives like the one in Kansas), but very few of them are provider-led. There are actually only three of them like ours that have that physician-hospital leadership. Most of them are led by business coalitions on healthcare," Tinsley said.
She said more than 90 Kansas hospitals currently are working with the collaborative with the goal of reducing hospital-acquired conditions by 40 percent and preventable readmissions by 20 percent by the end of 2014.
Participation is voluntary, but Tinsley said providers participate to improve patient care while reducing costs.
"Most of the work that's happening actually drives down costs. We're trying to prevent negative impacts to patients...and the costs come down on the back end from not having adverse events occur."
Tinsley cited dramatic improvement in two areas so far:
- Infections from IVs: This type of infection is one of the deadliest and costliest, Tinsley said. They can add up to 24 days to a hospital stay and cost between $7,000 and $29,000 per infection, according to Consumer Price Index. From 2010 to 2012, 39 participating hospitals reduced the incidence by 79 percent. Tinsley said before 2010, Kansas' rate was already below the national average.
- Infections from catheters: This type of urinary tract infection accounts for 30 percent off all infections acquired at hospitals and can add up to three days to a hospital stay, Tinsley said. They typically cost about $1,000 each to treat, according to Consumer Price Index. From 2011 to 2012, 23 participating Kansas hospitals reduced this type of infection by 48 percent.
Infant congenital heart defects
Rachel Berroth, director of the Bureau of Family Health at the Kansas Department of Health and Environment also testified to the committee on Monday.
She briefed the members on a public health initiative in development at KDHE aimed at detecting congenital heart defects in babies while they are still in the hospital following birth.
Currently, state law requires and pays for screening newborns for 29 metabolic and other health disorders by collecting a drop of blood from infants' heels.
But "critical congenital heart defect" is not among the conditions screened for, in part because it requires different equipment.
KDHE officials are surveying hospitals to see if they perform the screening and, if not, why. Berroth said that this summer, agency officials would craft a plan based on the survey results, including identifying hospitals to pilot the screening.
"By the end of the year, we'll bring on more facilities and continue with training, education, looking at the data and start monitoring so that we have incidence information for Kansas. That's something we don't have right now," Berroth said.
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