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April 2009

Leapfrog Hospital Survey Results Released

Leapfrog_Logo_Tagline The results of the 2008 Leapfrog Hospital Survey, released this week, suggest that hospitals still have tremendous work to do to be safe for patients. 

For example, sixty-five percent yet to put in place all of the recommended policies to prevent hospital-acquired infections (though this is an improvement from 87% in 2007).  Similarly, seventy-five percent do not fully meet the standards for thirteen critical safety practices from hand washing to the competency of the nursing staff.  Just 30% of hospitals are fully meeting the standards for preventing hospital-acquired pressure ulcers and only 25% are meeting standards for preventing certain injuries in the hospitals. 

The Leapfrog Group's Survey included 1,276 hospitals in 37 major metropolitan areas.

New Monograph on Hand Hygiene May Push Us Forward -- by Suzanne Delbanco, Ph.D.

Hand hygiene The Joint Commission, along with several partners, has just released a new framework for determining "when, why and how to measure compliance with hand hygiene."  The monograph, entitled Measuring Hand Hygiene Adherence: Overcoming the Challenges, is the result of a two-year collaboration among the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA), the World Health Organization (WHO) World Alliance for Patient Safety, the Institute for Healthcare Improvement (IHI) and the National Foundation for Infectious Diseases (NFID).

What's the big deal?  There has yet to be agreement about how to measure compliance with hand hygiene protocols. Without some standardization, it is very difficult to measure the comparative effectiveness of different interventions to improve and sustain hand hygiene practices.  And depending on the measurement method, hospitals may produce for themselves a false sense of security that their hand hygiene practices are sufficient when they are not.  My suspicion is that the more rigorously we measure hand hygiene practices, the more disappointed we will be with performance - that is, until we also implement successful interventions to drive and maintain improvement.

The monograph does not create a single international standard for measurement of hand hygiene practices, though it draws from examples from several countries.  It moves us closer, however.  So let's cross fingers and get to the hard work ahead.

At Arrowsight, we offer a powerful methodology for implementing many of the features and elements of measurement the monograph outlines.  Arrowsight's deep experience in video monitoring and feedback in other industries allowed us to jump start our efforts in health care.  Our work is too new to have been cited in the monograph, though we have recently briefed many of its authors.  With 24/7 video monitoring, a very large and continuous sampling process, rigorous quality assurance and near-real-time feedback to front-line staff, we are excited for our Hospital Video Auditing approach to be part of the solution going forward. 

As a side note, it may not be a surprise to readers that the project was underwritten by GOJO Industries, the makers of Purell hand sanitizer.

New Poll Suggests 18% of Americans Affected by Hospital Infections

24724244 Consumers Union conducted a poll during mid-March of more than 2,000 Americans to learn about their experiences with health care-associated infections, preventable medical errors and preventive care.  Almost one in five (18%) say they or an immediate family member have experienced a dangerous infection following a medical procedure. 

  • Sixty nine percent of these respondents said they had to be admitted to a hospital or extend their stay because of these infections.

One-third of the Americans surveyed report that medical errors are common in everyday medical procedures.

  • Thirteen percent have had their medical records lost or misplaced.
  • Nine percent have been given the wrong medicine by a pharmacist when filling their doctor's prescriptions.

The results of the poll were released at a Congressional briefing on reforming the health care delivery system with the American Cancer Society, the American Diabetes Association, and the American Heart Association, who together also released a joint statement.

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