Using Automated Systems to Reduce Infection and Contamination Risk in Your Hospital

The increasing rate of hospital-acquired infections costs U.S. hospitals up to $45 billion annually, says the Centers for Disease Control and Prevention, and the average cost per infection case is $15,275. Another troubling fact is that hospital-acquired infections, such a methicillin-resistant Staphylococcus auerus, are moving from ICUs into general wards.

Using automated systems is one way hospitals can better monitor and document isolation beds to reduce infection risk. Methodist Healthcare System in San Antonio was able to employ these systems to cut down on infection risk to patients as well as staff at their facility. In this article, several experts involved in Methodist's effort discuss the benefits of using automation to reduce infection risk.

Lack of communication
Documenting and designating isolation rooms were the biggest challenges for Methodist Healthcare System when it came to preventing the spread of infection. Susan Sewell, RN, vice president of patient management, says lack of communication led to the breakdown. "Often in the hospital setting, we are good at communicating in a silo, and we often forget that other people need to know specific data about a patient. A patient may be well documented as an infection case within the unit, but transportation personnel may not be told when moving someone to, say, radiology," she says. If they aren't aware, the transporter will move along to the next floor taking the dirty wheelchair, and the infection, with them.

Ms. Sewell says unit staff was also documenting isolation beds and infectious patients on paper for their specific area; however, this information was not communicated to key stakeholders throughout the organization, making it an ineffective approach. "We also tried to include stickers on patient charts and signage in a room if a patient was an infection risk, but often the documentation was taken down before housekeeping came to clean the room putting them at risk; if signage did remain and was seen by the housekeepers, housekeeping staff had to return to their housekeeping department to retrieve all the necessary supplies to appropriately clean the room — adding valuable minutes to the bed turn time and further delaying patient flow," she adds.

Methodist Healthcare System decided in order to cut the risk to both patients and staff, it needed to find a better way to communicate about at-risk patients.

Building a team
Methodist Healthcare System chose to work with Pittsburgh-based TeleTracking Technologies to develop its bed tracking management system. "We integrated the TeleTracking bed tracking system with our existing ADT system, so we can recall patient history data and use it in our patient flow technology," Ms. Sewell says.

Bed management is crucial to minimizing infection risk. TeleTracking's system includes a HIPPA compliant electronic bedboard, which displays patient information, including infection status. "The system tracks patients throughout every move in the hospital, and the patient boards help to educate patients and patient placement coordinators," Ms. Sewell says.

Housekeeping and transportation are also included in the loop, as information related to infection status is communicated electronically and proactively to each department. "The system has created increased awareness among staff members. Now everyone can know infection status and feel like part of the team. Before, housekeeping and transportation didn't know until they were already in the room," Ms. Sewell says.

Micki Lerch, FACHE, patient flow specialist with Avanti, a division of TeleTracking, says, "The transparency of an automated system enables other employees to help nurses in the process. It saves time. They are already at the admit board and can access the system."

Methodist Healthcare System took infection control through the system one step further by including a field for isolation need in its bed request system. Starting July 1, the isolation field must include an attribute or indicate "none" in order for the patient to be placed in a bed. This assures that isolation status is addressed in all admission source areas.

Ms. Sewell says, "We struggled when we first started the system to include that field when placing patients in beds. Now, we have made infection control one of the top priorities, supported by placing a hard stop on bed requests before infection status is known."

Once the bed request is put through, the system searches for available beds at any of Methodist Healthcare Systems' six hospitals that fit the attributes included with the patient, starting first with private rooms and then looking for other patients with similar diseases or attributes. "It creates a cohort of patients within the hospital," Ms. Sewell says.

Using data to cut infection risk
Even with an automated system, infections can still break through. Methodist Healthcare System has been able to leverage its system to prevent a repeat event.

"If there is an infection that gets through, staff members can go back and perform an audit and see the points where the patient has been as well as what assist staff has been in contact with the patient," says Joy Avery, RN, MSN, CEN, patient flow specialist with Avanti.

Ms. Sewell notes that data can be broken down even further. "It is important to have a system that is user friendly, so you can go in and adjust and add available alerts, such as dirty beds and infection status changes, to the system." The automated system also pulls key metrics, such as bed turnover time and patient flow data, which can be shared with nursing directors and senior leadership. "We are able to monitor every step in the process on a hospital-wide and unit-by-unit basis," Ms. Sewell says. "For instance, certain areas are an increased risk to patient safety if patients are held there, so we look at the system and track the time it takes us to place patients. By improving the process, we improve patient satisfaction, patient safety and patient flow."

A good automation system should allow the end users, typically nurses, to be comfortable with the system, so that they can easily input and access data. Ms. Lerch says, "You need to have the ability to easily identify what flow metrics you want to measure and to report these metrics. If they can see the metrics, it adds to accountability throughout the process."

Bringing the C-suite on board
A key strategy to improve patient flow efforts including infection control knowledge is the buy-in and support of senior leadership "You need buy-in from the top down," Ms. Sewell says. "We had reluctance when we decided to put a full-stop on patient placement before infection attributes were defined, but when we made the senior leaders and nursing directors aware of the impact, they supported our decision."

Ms. Avery agrees. "It takes senior leadership buy-in [to be successful] throughout the system, otherwise effect change and efficiency will not take place. Engagement is key," she says.

Learn more about TeleTracking at www.teletracking.com.