When improving patient care leads to higher quality combined with cost savings, everyone from the doctor to the patient wins. For teams at Baptist Memphis, that scenario has proven true–and continues to trend in the right direction–when they were tasked with improving Catheter-Associated Urinary Tract Infections (CAUTI) and Central Line-Associated Bloodstream Infections (CLABSI) rates. Through KATA boards and new communication tactics, costs associated with rates have trended downward, resulting in a savings of $2 million across the system, which represents a 50 percent reduction in the number of infections.
Increased costs associated with CAUTI and CLABSI can include everything from the need for more medications or treatment to a patient’s length of stay.
In 2011, Dr. Paul DePriest, Baptist’s executive vice president and chief operating officer, suggested implementing a quality process that involved more than simply providing written reports to hospitals.
“We provided monthly detailed reports so a hospital can see how they’re performing,” said Manesha Hathcock, director of Outcome Management who has been with Baptist for 18 years. Hoping to understand the challenges behind the CAUTI and CLABSI numbers, Baptist began holding monthly Quality Close meetings where CEOs, CNOs, physicians and senior leaders could gather to review all quality metrics.
“It’s a time when we can address issues, identify them, or physicians can discuss certain cases. With 25 to 30 people in a room and all the hospitals conferenced in, we can discuss interventions and affect the process,” said Manesha.
While other entities like Select Health Alliance (SHA), Baptist Trinity and Baptist Medical Group (BMG) join the meetings, the meeting is primarily designed for the acute-care hospitals. “It’s making a difference, and it’s important for everyone to know they are being successful,” said Manesha.
Every Monday through Friday from 8:30 to 8:45 a.m., a safety huddle happens at Baptist Memphis that includes up to 150 team members from all areas—-clinical, non-clinical, nursing, non-nursing. All employees are welcome to attend.
“We discuss what went well in the previous 24 hours related to CAUTI, CLABSI, and falls. We discuss events that happened and what could have been done to prevent the event. We discuss what we will do in the next 24 hours to make sure no one is harmed on our watch. We always start with positive stories and recognize staff for jobs well done related to preventing harm and/or enhancing the patient experience,” said Michelle Smith, chief nursing officer at Baptist Memphis.
“The Training Within Industry (TWI) and KATA work is going to take us to the next level. We have a goal to reduce CAUTIs, CLABSIs, and falls another 50 percent this fiscal year, and that’s more aggressive than the organization’s goals for us.”
The KATA and TWI work align directly with Baptist’s organizational goals. Thus, there is a KATA board for falls, CAUTIs, and CLABSIs. There is now associated TWI work (job instructions) going on to reduce variability in performance.
“For example, we are doing job instructions specifically related to reducing our CAUTIs: Foley catheter insertion, peri-care and handwashing. We are also going to launch job instructions related to CLABSIs,” said Michelle.
Michelle said Baptist Memphis also holds weekly shepherd groups composed of managers, directors, and senior leaders to discuss KATA boards and progress. “We also have a shepherd group that meets weekly to discuss the job instruction work and make sure that it stays aligned with the KATA work and thus with the A3s for our organization.”
With increased communication and structured feedback, Baptist Memphis’ success has far surpassed the value of a dollar to touch patient lives, Michelle said.
“The daily safety briefing is a way to bring that work to a point of daily discussion…we talk about the people who are still here in our care.”