One of the more encouraging developments in our field the past few years has been a heightened emphasis on improving patient quality. While quality of care has always been the most important job of any hospital, we have gotten more aggressive and more direct about measuring the factors that we know lead to better patient outcomes.
Just in the past few weeks, the Centers for Disease Control reported that between 2008 and 2012, hospitals had reduced central line-associated bloodstream infections by 44% and surgical site infections by 20%. The CDC also found that MRSA infections, hospital-acquired infections, and C. difficile infections had all decreased in recent years.
So while hospitals have always concerned themselves with quality of care, an industry-wide focus on measurable factors has produced tangible results that we know equate to better care. This is the trend within our industry, and I am proud to say that New Hanover Regional Medical Center is at the forefront of this movement.
Among our Board of Trustees, whose members are constantly reviewing our quality metrics, and through every department there is an awareness of what the quality measures are and how we meet them.
Most anyone who works here can tell you one of our quality goals is for all patients to receive, at all times, “perfect care” (which means every patient with certain disease states receives every component of scientifically based care for which they are eligible). These “perfect care” goals are often referred to as “core measures.” Our results so far this fiscal year for these measures are 99.52%, an outcome well ahead of national standards, and one we’re working to improve.
One of many quality goals we constantly track is related to cardiac attack. We measure the time it takes for a patient in cardiac distress to reach a catheterization lab and have a cardiologist resolve the artery blockage. Our average time from when a patient arrives complaining of chest pain until a cardiologist has resolved the problem is 39 minutes. The average time for a U.S. hospital is 59 minutes, and hospitals in the top 10 percent average 47 minutes or less. We’re proud to say NHRMC is at or near the top of our field for this vital metric.
We also measure how often our patients readmit to the hospital within 30 days of discharge – actually, the federal government measures it for us as a way to control costs for its health care plan. Only 20% of North Carolina hospitals have not been penalized for excess readmissions, and we’re proud to be among that group.
We measure the mortality rate of patients with sepsis. The nationally accepted range is 25% to 40% - our rate is 16%. We measure “hospital acquired conditions,” or the rate of infections or other conditions that ensue after the patient reaches the hospital. Our rate is typically about 15% below the national benchmark.
We are particularly proud of our work in this area. Among hospitals reporting to the database in North Carolina that we use, we have the lowest infection rate.
We have made efforts to “control” infections for as long as NHRMC has been open. But in recent years, the focus has been to prevent them by eliminating the underlying causes we know lead to infection. The results have been astounding.
Our Surgical/Trauma Intensive Care Unit has had one central line-associated bloodstream infection (or “CLABSI”) in more than two years. Our Pediatric Intensive Care Unit has never had a CLABSI since it opened in 2008. Our Neonatal Intensive Care Unit has had two in three years.
That’s an interesting statistic, but what does it mean in everyday terms to practically eliminate bloodstream infections, in this case, from our NICU? It means more babies go home with their parents. Based on national standards for infections, we have prevented enough deaths through improved quality of care in recent years to start a kindergarten class.
That’s the underlying story behind these statistics. We are not collecting numbers for their own sake, but focusing on the things we know cause people to live longer, stay healthier and return to productive lives. Though we invest significant resources in our quality programs, their success saves significant dollars for New Hanover Regional Medical Center, our patients and our community. But most of all, we do it because it’s the right thing to do.
So we welcome the attention that hospital quality is beginning to receive at a national level. It’s a story we’re all too happy to tell here in Southeastern North Carolina. Of all the things we do to make our patients’ lives better, none is more important than taking care of them the right way.