Miami-based Jackson Memorial Hospital has reduced its hospital acquired infections by 40% in about nine months with two changes.
The system implemented two new processes: line rounds and "ticket to test."
"The first step was eliminating any tubes or lines that are unnecessary," Hany Atallah, MD, chief medical officer at the hospital, told Becker's. "The second part involves nursing care: taking good care of the lines we have, questioning physicians about the necessity of a tube or line and determining when it can come out."
Line rounds have reduced the use of unnecessary tubes and lines, which are potential sources for infection. This method has had the biggest impact on preventing HAIs, Dr. Atallah said.
The "ticket to test" process is designed to ensure there is a reason behind each culture test ordered. Orders must meet certain criteria and in many cases are discussed between physicians and nurses. In some cases, the tests are canceled upon reconsideration but if there is a disagreement, the test is escalated to a physician leader to review.
"This process has helped eliminate unnecessary cultures that sometimes catch incidental infections," Dr. Atallah said. "It's also helped us be good stewards of our resources."
Both efforts began about nine months ago and have resulted in a 40% reduction in HAIs across the board, "and some infections show even higher reduction," Dr. Atallah said. "This collaborative effort, although time-consuming, is well worth it as it significantly benefits our patients."
There was some hesitancy among physicians when implementing these changes, though Dr. Atallah said the patient outcomes have mitigated those concerns.
"Initially, we heard concerns from physicians who felt we were limiting their ability to order cultures," he said. "We clarified that this system is not meant to inhibit ordering cultures but to ensure thoughtful consideration before doing so. The same applies to line rounds, where we assess whether a patient truly needs a line or tube. The results speak for themselves."