Submitted by Ryan O’Connell
This story is a team effort co-authored by physicians, nurses, and respiratory therapists featured in the below video. Through a multi-year, ongoing effort to improve value—to patients and providers—our hospital and health system teams have been guided by a basic tenet: providing care without inappropriate variation reduces costs. Specifically, through the teamwork of clinical, quality, and finance leadership, we have found that the “profitability” of the care we provide is consistently higher when our patients do not suffer harm. Together, we have developed a set of indicators that portend avoidable harm in patients. In the attached video, we attempt to (briefly) illustrate the identification and mitigation of one of those particular adverse event indicators—ventilator associated pneumonias(VAP)—that had unacceptably high rates. We were able to decrease tot al cost of care from about $1,375,000 in FY’2012 to just about $75,000 in FY’2015. By use of a combination of reliable adherence to best practice guidelines, agreement among all physicians on a management protocol, and rigorous reporting and measuring, our hospital was able to decrease the number of ventilator associated pneumonias from 18 cases in FY’12 to 10 cases in FY’13 to 5 cases in FY’14 to just one case in FY’15 (with 2 days left in the fiscal year!) Ventilator associated pneumonia is a dread complication of ICU care, associated with significantly increased hospital length of stay and concomitant other morbidities for patients, such as going to a nursing home instead of home, and even increased rates of death. By dramatically decreasing VAP across our three critical care areas, we prevented many patients—and their families—suffering this avoidable complication, and cost of care for this complication dropped by about $1,275,000.
Take a look! –