A quality improvement program at Johns Hopkins Hospital in Baltimore that changed organizational culture to emphasize patient-centered care reported reduced infection rates, lowered hospital costs and shortened hospitalizations for surgery patients.
Patients undergoing colon and rectal operations at the hospital experienced shorter hospitalizations, reduced infection rates and lower hospital costs, according to the study, published online in the Journal of the American College of Surgeons. The results were attributed to changes in the surgical care process and clinical interventions made based on evidence-based best clinical practices.
The new standardized care plan, called an Integrated Recovery Pathway, was first implemented 11 months ago. Since then the incidence of surgical site infection has decreased by more than half.
"We had executive support coupled with participation from the frontline healthcare staff so this QI effort was a priority for everyone," Elizabeth Wick, MD, prinicipal investigator and associate professor of surgery and oncology at John Hopkins University School of Medicine in Baltimore, said in a statement. "We consistently kept the patient at the center of care."
The program began with changes in hospital infrastructure directed toward improving surgical teamwork and patient safety, according to Dr. Wick. This was followed expansion on the existing safety program with the aim of improving patient outcomes, value and experience. To help better this experience, the same teams of providers worked together in the operating rooms and all colorectal surgery patients stayed in a single inpatient unit post-operation.
Here are eight key findings reported in the paper:
• The average hospital stay decreased from seven days to two days.
• Patient-reported satisfaction regarding communication with staff about medications rose from 52 percent to 71 percent.
• Patient-reported satisfaction regarding staff responsiveness to requests rose from 24 percent to 34 percent.
• Patient-reported satisfaction regarding pain management rose from 68 percent to 77 percent.
• On average, the SSI rate decreased from 18.8 percent to 7.3 percent.
• Average direct costs of a hospital stay fell by more than 17 percent, from $10,933 to $9,036.
• Rates of UTI fell from 4.1 percent to 1.6 percent.
• Rates of deep vein blood clots fell from 3.5 percent to 1.6 percent.
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