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“As part of an ongoing commitment to quality care and infection prevention, nationwide doctors and hospitals are partnering with Kimberly-Clark to deliver continuing education programs on healthcare-associated infection (HAI) prevention to staff and management. As simple as education sounds, busy doctors and nurses on the front lines of delivering care can find it difficult to find the time to take advantage of scheduled programs within their hospitals.

The HAI Education Program is part of a national infection awareness campaign for healthcare professionals called “Not on My Watch” and will provide the facility with a toolkit that contains informational flyers, patient safety tips and posters.

The “Not on My Watch” campaign provides accredited continuing education (CE) programs based on best practices and guidelines as well as research available on reducing the incidence of healthcare-associated infections.”

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“Most errors are committed by good, hardworking people trying to do the right thing. Therefore, the traditional focus on identifying who is at fault is a distraction. It is far more productive to identify error-prone situations and settings and to implement systems that prevent caregivers from committing errors, catch errors before they cause harm, or mitigate harm from errors that do reach patients.”

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“Despite being reported over a decade ago, little has been done in America to reduce hospital born infections as per a Health and Human Services department quality report for 2009 to Congress. Hospital acquired infections seem to be on the increase according to the report when compared with statistics available for 2007. The situation is being seen as critical by many health care experts.”

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Plexus Institute’s Lisa Kimball comments, “In 2006 in an effort spearheaded by Plexus Institute, six Beta Site hospitals, CDC, Positive Deviance Initiative, and Delmarva Foundation came together to pioneer the first use of Positive Deviance (PD) to reduce the transmission of MRSA (methicillin-resistant staphylococcus aureus) in healthcare organizations. The article, published by the Association for Professionals in Infection Control, presents the work of these hospitals, the results they achieved which include dramatic sustained reductions, a primer on PD, and suggestions for employing PD to prevent MRSA.” See Staff-Driven Cultural Transformation Diminishes MRSA

Dr. Peter J. Pronovost, 45, is medical director of the Quality and Safety Research Group at Johns Hopkins Hospital in Baltimore, which means he leads that institution’s quest for safer ways to care for its patients.

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An international team of researchers has used high resolution genome sequencing to track a particularly virulent strain of MRSA as it traveled between South America, Europe and Southeast Asia. The findings shed light on how these deadly bacteria are able to spread from patient to patient in a single hospital and, on a larger scale of geography and time, between countries and entire continents.

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The PBS News Hour with Jim Lehrer has featured the Billings Clinic (see Chapter 3) as an example of how high quality health care can be provided at relatively low cost.

In a special segment of the program, aired August 12, health correspondent Betty Ann Bowser visits the clinic, in Billings, Montana, and talks to doctors about the clinic’s model of integrated patient care and clinic’s participation in a Medicare project designed to reduce costs and improve patient outcomes. The segment opens with President Obama citing the Mayo Clinic and the Cleveland Clinic as examples of providers of high quality and lower cost care, and asks the question: what are they doing that’s different?

Billings, which is modeled after the Mayo Clinic, is introduced as another facility that is doing differently, and better. With 3,500 employees, it is the largest multi-specialty medical group practice in the state, and treats 148,000 patients annually at a dozen locations. Physicians at Billings, even the high end specialists, are employees who are paid a salary, rather than working as independent contractors. Dr. Doug Carr, medical director, says that means doctors are paid for care of patients, without regard to the type of insurance reimbursement the patient has or the number of tests ordered.

Two years into the Medicare project, the average annual expenditure per Medicare patient at Billings is $6,332, well below the national average of $8,304. Dr. Carr says coordinated care, including the benefits of a telemedicine program for patients at a distance, saved $1.5million in avoided hospitalizations.