If a hospital is facing a problem with quality or safety, chances are another facility is having the same problem. That's especially the case with hospital-acquired infections, which can kill over 100,000 patients a year.
So, a group of providers is teaming up to share best practices on how to fix those problems in a way that enlists Lean management, a philosophy of eliminating waste through constant improvement and incremental changes to an organization's processes.
The Catalysis Healthcare Value Network is made up of 72 providers who engage in ongoing discussions around quality and safety. Catalysis, an Appleton, Wis.-based not-for-profit, connects health systems, provides education and coaching about Lean transformation and coordinates on-site visits at member health systems so members can see the real solutions in action. Membership costs $25,000 a year. Catalysis organizes about 20 on-site visits a year, in addition to hosting webinars and a two-day conference.
One of the solutions currently being disseminated across the Catalysis network attempts to limit bloodstream infections that originate from a patient's central line catheter, a long-term intravenous medication line placed into a large vein in the patient. U.S. hospitals have made strides in reducing the rate of central line-associated bloodstream infections, or CLABSI, but the deadly complication still affects over 30,000 patients a year and has a 12% to 25% mortality rate, according to the Centers for Disease Control and Prevention. That has cost the U.S. healthcare system over $1.8 billion since 2001.
Catalysis member Salem (Ore.) Health is resolving its CLABSI problem by standardizing processes and implementing frequent evaluations of patients' need for a central line. The result is a 64.3% drop, from 14 infections in its fiscal 2015 to five infections in 2016, according to Debbie Goodwin, Salem Health's in-house Lean expert.
As a part of the solution, Salem staff outlined specific roles and steps for central line cleaning, changing, or removal that should be followed the same way every time for every patient. Cleaning staff are taught a standardized procedure, to ensure that room conditions aren't the root cause of infections.
Solutions across the Catalysis network often stress standardization because a culture of bad habits or neglect can spread across an organization and lead to poor outcomes, said Paul Pejsa, director of the Catalysis network.