Hospital-acquired infections (HAIs) are dangerous. Sepsis, for example, which can result from an HAI, is the leading cause of death in hospitals, accounting for nearly 270,000 deaths in America each year. Unfortunately, data suggests the COVID-19 pandemic exacerbated HAI rates in many hospitals. Research cited by NEJM Journal Watch shows that central-line associated bloodstream infections rose significantly during the pandemic.
Becker's Hospital Review recently spoke with Anna Daly, VP of data analytics and innovation at Conduent Healthcare, about HAIs, the vexing challenges associated with sepsis and the importance of sepsis prevention programs that leverage data to improve sepsis outcomes.
Sepsis is the top HAI challenge within hospitals
"It's going to take a while for us to get back to that pre-COVID state where we were hyper-vigilant and hyper-aware [of HAIs]," Ms. Daly said. But while COVID-19 may have temporarily overshadowed sepsis, Ms. Daly conveyed, "For many years, sepsis has been the number-one challenge and the costliest disease process for hospitals." Data from the Sepsis Alliance bears this out:
- Sepsis is the number-one cost of hospitalization in the United States; costs for acute sepsis hospitalization and skilled nursing are estimated to be $62 billion annually.
- The average cost per hospital stay for sepsis is double the average cost per stay across all other conditions.
- 19 percent of people hospitalized with sepsis are readmitted within 30 days. Sepsis is the number-one cause for hospital readmissions each year, costing more than $3.5 billion annually.
Sepsis has remained a vexing problem, Ms. Daly said, "because providers struggle to pinpoint the exact time when a patient is turning septic. It is a big challenge."
Data and processes are the keys to an effective sepsis prevention program
"Data is absolutely critical for any sepsis prevention program," Ms. Daly said. This includes historical and retrospective data showing what happened in previous weeks and months. It also includes real-time data to show what is happening right now. "Most hospitals today have a very strong infectious control team that lives and breathes the infections within the hospital; their entire job is to eliminate or reduce the amount of infections within the hospital system," Ms. Daly explained.
She continued, "Data is absolutely required from them; to be able to do what they do, they need data on a daily basis. They need to understand where pockets [of infections] are occurring within their hospital system and which providers may be having a harder time managing their infectious populations."
Ms. Daly summarized, "Being able to drive control of their systems requires looking at their data."
As important as data is, looking at real-time data from EHRs to address sepsis on a case-by-case basis does not improve outcomes at scale. Improving sepsis results requires transforming processes. Ms. Daly emphasized the importance of having consistent, standardized processes around sepsis encounters — developed based on best practices — and constantly monitoring these processes.
Hospitals and health systems need to take a data inventory to understand what they have and what they need
Hospitals and health systems have enormous amounts of data. But Ms. Daly stressed, "Not all data is actionable data; some data is just noise that is bogging down the system."
Having an effective sepsis prevention program starts with taking an inventory of the data the organization has and determining the data that is needed to prevent sepsis. "Most of the time, hospitals have the data they need; they just don't know they have it or they don't know how to put it together in the right manner," Ms. Daly said.
She suggested organizations develop key sepsis metrics that alert an infectious control team that a patient is at risk of going septic. Teams need a framework where information is easily consumable by the infectious control team in real-time, so they know when to take action to improve outcomes. Analysis of data can also identify when and where process improvements are needed.
"Build your strategy around the data that you have available," Ms. Daly said. "How can you use the data that you have and get it in the hands of the people who are responsible for the infection control of the facility and the providers who need that information to make life or death decisions on a daily basis."
Conduent provides tools to help hospitals and health systems harness the value of data to improve sepsis outcomes
Conduent has developed two tools that help hospitals address their sepsis populations.
1. Datavision. This robust application tracks and examines clinical utilization and provider trends. Datavision evaluates high-risk populations, measures sepsis compliance and analyzes key performance indicators such as mortality, length of stay and readmission. "Hospitals can track their patients from a quality performance perspective, from a compliance perspective and can look at . . . things that would directly affect their reimbursement," Ms. Daly said.
CMS has recommended specific standards and protocols for sepsis management. Clinicians, documentation specialists and coders need to collaborate to ensure that sepsis is properly documented and treated to ensure compliance with CMS Core Measures and to help drive overall improved patient outcomes. Hospitals and health systems monitor overall mortality rates, as well as mortality rates by specialty, physician, length of stay, readmissions and the impact of performance improvement strategies.
2. Sepsis Insights Dashboard. This dashboard aggregates retrospective data and real-time data into a single user-friendly experience. Conduent identifies critical and actionable data to streamline the data analysis process for healthcare providers, improves response time to gaps in care and quickly identifies opportunities for improvement. "It allows clinicians to go to one place to see how well they're managing their sepsis populations," Ms. Daly said. "They're not having to bounce around between different dashboards or go to different reports to find this information."
Hospital and health systems that utilize Conduent's Sepsis Insights Dashboard can monitor the performance from a high level (entire facility) down to a detailed patient level. It has been built specifically for clinicians by clinicians. Quality teams can quickly drill through the data to identify provider and patient trends. The dashboard can be used by everyone in quality management and process improvement, including chief medical officers, chief nursing officers, sepsis task force members, providers and nurses. The sepsis insights dashboard aims to save patient lives.
Hospitals and health systems use the Sepsis Insights Dashboard for the following outcomes and benefits:
- Drive performance improvement. The Dashboard identifies opportunities for quality and process improvement and enables tracking and trending compliance with sepsis workflows and provider performance. The result is improved sepsis management.
- Improve patient outcomes. Through use of the Dashboard, hospitals and health systems are able to reduce readmission rates, length of stay and mortality rates, as well as quickly identify gaps in care and delays in diagnosis and treatment. Benefits include increasing compliance with CMS Core Measures and most importantly — saving patient lives that would have been lost due to sepsis.
- Leverage predictive analytics. The Sepsis Insights Dashboard provides users with guided predictive analytics. The idea is to use predictive analytics to reduce adverse events, decrease patient mortality rates and reduce costs. Overall, predictive analytics provides the promise of improved management of observed and expected mortality values for the sepsis population.
"It's not 12 pages of bells and whistles. It's a single page that has drill-throughs for greater detail," Ms. Daly said. "It's got all of the information that users need in order to drive the betterment of their sepsis population."
These tools deliver on Conduent's goal, which Ms. Daly stated is "making sure you get data into the hands of those folks [the clinicians] in a way that they can actually take action on it."
To learn more about Conduent's advanced analytics solutions visit Conduent.com/HealthInsights or email them at HCProvider@conduent.com.