Innovation Spotlight: New York Hospitals Are Improving Health, Enhancing Quality, and Reducing Costs.

Mercy Medical Center enhances sepsis care

According to CDC, at least 1.7 million adults in the U.S. develop sepsis and nearly 270,000 die as a result each year. In 2014, Mercy Medical Center (of the Catholic Health Services of Long Island system) formed a sepsis committee made up of medical staff from various departments. The team evaluated timely nursing assessment, early identification of barriers, improving caregiver education and the addressing of medical record challenges.

The sepsis committee took data from the evaluations and developed a Mercy Sepsis Program that implemented an intensive and multidisciplinary education program for clinical staff and their patients. The plan evaluated the most at-risk patients based on extensive data review, customizing the existing sepsis protocol and outlining opportunities on how to reduce the risk of sepsis. Additionally, the plan highlighted the importance of patient engagement and empowerment, The Program requires clinical staff to participate in annual multilevel sepsis education. It also:

  • implemented sepsis rapid response calls;
  • designed a nurse’s sepsis work sheet to improve communication from unit-to-unit and nurse-to-nurse;
  • used electronic medical records to support the sepsis bundle with early warnings and reminders built in; and
  • created an electronic sepsis screen where every patient, every day, on every shift is screened for sepsis.

In 2018, Mercy was recorded in the 97th percentile for three-hour bundle compliance and in the 98th percentile for the composite bundle adherence. Their sepsis order set usage increased from 36.6% in 2015 to 95.1% in 2018. The current median time to antibiotic is 33 minutes with a mean of 48 minutes.

For more information, contact Alida Almonte, director, public relations, at alida.almonte@chsli.org or at (516) 705-1871.

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SUNY Downstate Medical Center halts healthcare-associated infections

Healthcare-associated infections kill more than 72,000 patients yearly in the U.S. The Centers for Disease Control and Prevention states that the most effective way to stop the spread of infection is to ensure that caregivers have clean hands, but monitoring care providers is tedious and limited, leaving staff and patients exposed to a higher risk of infection transmission.

In 2018, SUNY Downstate Medical Center launched a novel initiative to improve hand hygiene with the new, state-of-the-art BioVigil system to prevent HAIs and increase hand hygiene compliance. The colored lights on the BioVigil badge visually communicate hand hygiene compliance. Red is stop and wash hands; yellow is a reminder; green means hands are clean. This provides reassurance to patients and families that their care provider has clean hands and helps providers track their hygiene. One patient’s family member, after noticing a BioVigil badge, commented that he was “very impressed and had a huge sense of comfort not to worry about germs and diseases being transmitted because of bad [hand] hygiene.”

In less than eight months, Downstate recorded nearly six million hand hygiene occurrences, roughly 803 an hour. In addition to increasing patient quality and satisfaction, hand hygiene compliance increased by 200% and the numbers are still climbing. Cross-contamination events were reduced by 50%.

For more information, contact Robert Gwizdala, MPH, RN, director, epidemiology and infection control, SUNY Downstate Medical Center, at (718) 270-2344 or at robert.gwizdala@downstate.edu.

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Health Quest reduces sepsis mortality

Sepsis is a serious threat to patient safety and public health. It has been found in more than one-third of patients whose hospitalization culminated in death, and inpatient care for sepsis is a crucial and substantial cost driver for hospitals. In 2017, Health Quest implemented steps to reduce sepsis mortality.

Multidisciplinary sepsis committees were created at each hospital with representation from inter-departmental staff. Committees reviewed common areas of weakness in the sepsis protocol, including timely nursing assessment, early identification of barriers, caregiver education, electronic medical record challenges and alarm fatigue. Using committee recommendations, annual sepsis education modules were established, a rapid response code was instituted and education on early sepsis recognition was provided to care partners. Committees then focused on identifying the most at-risk patients based on extensive data review and customized the existing sepsis protocol to address opportunities they found. The protocol is continually reviewed and revised as needed.

The sepsis mortality rate decreased from 20.7% in 2013 to 7.8% in 2017. The sepsis mortality ratio decreased 54% from 2013 to 2017. Health Quest outperformed the New York State average by 25% for three-hour sepsis bundle adherence and outperformed the state average by 70% for composite sepsis bundle adherence.

For more information, contact Diane C. Kantaros, MD, Associate Vice President, Clinical Quality, at (845) 475-9734 or at dkantaros@health-quest.org.

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Northwell Health provides behavioral health treatment to students

Studies show psychological distress in students is tied to lower academic success. Additionally, college is an especially vulnerable time for individuals’ mental health, with students often at greater risk of depression, anxiety and substance abuse. Northwell Health launched the Behavioral Health College Partnership at Zucker Hillside Hospital in 2009 to provide rapid, comprehensive mental health treatment to area college students.

At the point of crisis, students are met with a college public safety officer and paramedic trained to deal with psychiatric crises and taken to Long Island Jewish Medical Center's ED for assessment. This avoids a 911 call, which can be embarrassing for students and can inhibit their attempts to seek care. If inpatient care is needed the program has a special unit (located at Zucker Hillside), a welcoming, dorm-like environment catered to young people that allows for a sense of normalcy as students stabilize. Moreover, the program works with college counselors and administration throughout the treatment process to ensure successful transfer of the patients back into the school environment.

More than 3,200 students have been admitted to the Partnership since it began. Seventy-seven colleges in the New York metropolitan area currently participate in the program. In 2017, the Partnership was launched at Northern Westchester Hospital to serve local colleges.

For more information, contact Laura Braider, PhD, Director, Behavioral Health College Partnership, Zucker Hillside Hospital, Northwell Health, at (516) 410-5903 or at lbraider@northwell.edu.

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NewYork-Presbyterian supports overdose survivors through the Relay Program

According to CDC, unintentional drug overdoses killed more than 70,000 Americans in 2017, a 10% increase over 2016. Every six hours a person dies from an overdose in New York City and more than 80% of those deaths involve opioids. In 2017, hoping to reduce opioid-use mortalities, NewYork-Presbyterian began offering the Relay program.

When a patient experiences an opioid overdose, NYP notifies Relay and a “wellness advocate” with personal substance abuse experience arrives within an hour to offer patients naloxone kits, refer them to medication-assisted treatments and assist in obtaining needed social services such as housing or health insurance. Patients can work with the wellness advocate for up to 90 days. NYP also educated staff on treating addiction patients, focusing on non-opiate pain relief options and collaborating with community-based organizations to get treatment. Additionally, NYP has been providing free kits and conducting public training sessions on how to administer naloxone.

Since Relay’s launch, 157 overdose survivors from NYP have chosen to participate in the 24/7 program and more than 900 naloxone kits have been distributed through Relay, with 60% of recipients saying it was their first time receiving a kit.

For more information, contact Lauren Browdy, Media Associate, Communications, NewYork-Presbyterian, at (646) 951-2898 or at lab9125@nyp.org.

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