HAP Achievement Awards Winner Spotlight: Hahnemann University Hospital
March 02, 2018
Incredible work is being done across the state as Pennsylvania hospitals work to improve the quality and safety of patient care. This week, we’re sharing the award-winning program developed by Hahnemann University Hospital to reduce its rate of Clostridium difficile (CDI).
More than half of all hospitalized patients will get an antibiotic at some point during their hospital stay, but studies have shown that 30–50 percent of antibiotics prescribed in hospitals may be unnecessary, posting an increased risk of acquiring CDI.
Despite a 90 percent or better adherence to hand hygiene, contact isolation, and room cleaning practices, Hahnemann University Hospital’s rate of CDI continued to increase.
The organization developed a comprehensive, multidisciplinary plan of action, starting with an internal investigation that led Hahnemann to theorize that there was an overuse of levofloxacin and an overuse of the toxin text, which in turn led to unnecessary testing and treatment of colonized patients.
Hahnemann developed and implemented a multi-disciplinary plan to address this, which included:
- The Pharmacy Department’s improved enforcement of existing antimicrobial restriction policy and conduction of one-to-one clinician education and group in-services for physicians on the optimal use of antimicrobial therapy, use of the antibiogram, and treatment pathways
- The amendment of the existing nursing policy for early detection of CDI—including developing symptom assessment guidelines for nurses and clinicians—and the education about the updated policy and guidelines for risk factors, symptoms, and isolation
- The incorporation of a near-real-time review by Infection Prevention and Control staff of all cases of positive CDI toxin to verify that the testing criteria are met and provided positive and negative feedback about each case
The comprehensive plan of interventions, coupled with the education, opened up a dialogue with the entire health care team to support and embed a true culture of improvement and:
- Reduced the CDI rate from 3.03 per 1,000 patient days to .32 per 1,000 patient days
- Decreased the use of levofloxacin defined daily dose from 56.5 per 1,000 patient days to 25.8 per 1,000 patient days
The program included the structure and processes to sustain the culture of patient safety and high quality care by having the team continue to meet and review data, current and best practices, disseminate findings with the entire health care team, and continue to provide ongoing education.
Congratulations to Hahnemann University Hospital for receiving a 2017 HAP Achievement Award. Learn more about their effort as well as the other 2017 award-winning programs at HAP’s website.
HAP recently issued its 2018 HAP Achievement Awards program’s call for entries in the following categories:
- Community Champions
- Optimal Operations
- In Safe Hands
- Excellence in Care
- Living the Vision
Entries are due March 23 and the winners will be recognized during a special award luncheon during the 2018 Leadership Summit.
Questions about the HAP Achievement Awards may be directed to HAP Member Services at (717) 561-5359.