Published by: Caroline Jacobs on 10/20/2010 3:03:06 PM
In her monthly magazine, Oprah Winfrey ends each issue with a column entitled “What I Know for Sure” where she talks about an issue she feels strongly about. I’m going to borrow Oprah’s strategy for today’s blog post.
What I know for sure is that it is within the power of healthcare organizations to “Get to Zero” healthcare acquired infections or, certainly, extremely close to zero. In fact, we in healthcare have a professional and moral obligation to our patients, communities, and colleagues to shift our mind-set from one where infections are viewed as an unfortunate byproduct of our work to one which emphasizes a zero-tolerance for infection. And, I might add, we should desire to achieve this goal without being told to do so by external review agencies such as The Joint Commission, the Centers for Medicare and Medicaid Services or state regulatory agencies.
Some may say that zero is impossible - I disagree. Every single day multiple healthcare organizations across this nation demonstrate that zero is possible by: reducing variation in clinical practice via standardization; implementing evidence-based “bundles” of clinical practices; practicing appropriate hand-hygiene; and, providing culturally and linguistically appropriate patient and family education on infection reduction strategies so that our primary customers also understand how to keep themselves safe. This, my friends, is not rocket science. It does, however, require unwavering clinical and administrative commitment to achieving the goal and the will to hold ourselves individually and organizationally accountable for making safe behavioral choices vis a vis patient care.
In the spirit of transparency, my organization has not as yet “Gotten to Zero” but we are on the right road and challenging ourselves to get better. We have reduced our system-wide rate of ventilator associated pneumonias from 7.6 per 1,000 ventilator days in 2005 to 1.2 per 1,000 ventilator days Y-T-D in 2010. Over the same time period, we reduced our central line bloodstream infection rate from 10.7 per 1,000 central line days to 2.8 per 1,000 central line days Y-T-D in 2010. Several of our facilities have gone for upwards of 9 months without one ventilator associated pneumonia on an adult ICU. Our teams have made enormous progress, and we are certainly proud of what we have accomplished. But we are not where we want to be.
What I know for sure is that healthcare acquired infections are fully preventable if we have the will and choose to eradicate them. Let’s work together and challenge ourselves to “Get to Zero.”
Caroline M. Jacobs, MPH, MS Ed
Senior Vice President, Patient Safety
New York City Health and Hospitals Corporation