Christ Hospital, a tertiary-care facility in Cincinnati, performs cardiac surgeries on more than 900 patients per year, as many as half of whom enter via the emergency room and are urgently catheterized. As part of the 440-bed facility's ongoing improvement efforts, in April 2003 Christ Hospital established a cardiac surgery protocol that has reduced staphylococcus aureus surgical-site infections by 75%. For these efforts, the hospital has received an honorable mention for the Spirit of Excellence Quality Award.
Based on a study that cited intranasal mupirocin as a way to prevent certain postsurgical infections, cardiac surgery units obtained nasal cultures on all patients and immediately began treating them. If the culture returned negative, mupirocin was halted; otherwise, it was continued for a week. This costs the hospital an estimated $44,000 per year, but since the average cost per patient for treating such an infection was $42,766 in 2002, that means if one infection is prevented per year, the program pays for itself.
"We figured if we could reduce (infections) by just one, we would pay for the cost for all the patients," says Deborah Hayes, vice president of patient services. "And we have dramatically reduced the numbers," from a rate of 1.28% to 0.32%, saving as much as $340,000 per year.