Penn Highlands Healthcare Hospitals Perform Well in DOH Study

Penn Highlands Healthcare was extremely pleased with a recently released state Department of Health report verifying that a low number of infections occurred related to the care provided at the system’s four hospitals: Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk.

The state Department of Health’s 2014 Healthcare-Associated Infections (HAI) Report shows that Pennsylvania hospitals have made significant progress in reducing these medical complications while reducing healthcare costs that would have been associated with infections.

Healthcare-associated infections are infections that patients develop during the course of receiving healthcare treatment for other conditions while in the hospital. One of the most common fears patients have about coming to the hospital is developing an infection. Penn Highland Healthcare’s effort to eliminate healthcare-associated infection aligns with its commitment to minimize fear and enhance the patient experience.

Among the types of healthcare-acquired infections in the study included bone and joint; blood stream; central nervous system; cardiovascular; eye, ear, nose and throat; gastrointestinal; lower respiratory tract; pneumonia; reproductive tract; skin and soft tissue; surgical site; systematic; and urinary tract.

Also reported was the percentage rate of flu vaccinations among healthcare workers. Influenza vaccinations assist in promoting a healthy workforce to care for patients; therefore, Penn Highlands Healthcare implemented a policy requiring employees to have a yearly flu shot.

“Quality, safety and process efficiency are more important than ever in healthcare. Penn Highlands Healthcare is well positioned for success in each of these areas. I commend our four hospitals and their physicians, advanced practice providers, nurses and staff for their commitment to advancing quality of care and patient safety,” stated Gary DuGan, M.D., chief medical officer for Penn Highlands Healthcare.

Here’s a snapshot of how the four hospitals performed:

Penn Highlands Brookville

Penn Highlands Brookville continues to show a low infection rate, according to Amy Fraccola, Director of Organizational Performance Improvement/Patient Safety Officer.
She explained that one of the initiatives that has been helpful is an effort to decrease device utilization. Physicians and nurses receive daily reminders/alerts asking if a device such as a urinary catheter or a central line continues to be necessary in the patient’s care. The infection prevention specialists also have a patient screen that provides infection data that is easily analyzed. With information easily accessible, Fraccola said reviews and recommendations can be completed more efficiently and effectively in communicating to physicians and staff.

She also said that patient participation is also an essential component of infection prevention.

“In daily rounding and interactions with patients, many patients are aware of necessary hand washing requirements and voice expectations that staff perform this task during their care. The other initiative that is important is isolation precautions. When patients are identified to have infections that could be easily spread to other patients, isolation precautions are necessary to prevent other patients from becoming infected,” she explained.

Fraccola further noted that the influenza vaccination rate for Brookville employees was 92 percent.

Penn Highlands Clearfield

According to Catherine Civiello, PhD, Director of Performance Improvement, Penn Highlands Clearfield continues to demonstrate an overall lower rate of healthcare-associated infection than is the average for Pennsylvania hospitals.

During the study year of the report, she said the number of healthcare-acquired infections reported at Clearfield were well within the predicted range for the number of patient days. The infection rate per 1,000 patient days was 0.27. Civiello said this figure represents a 54 percent decrease from 2013 (that rate was also within the expected range).

Penn Highlands Clearfield is pleased that its patient safety efforts resulted in zero infections of the lower respiratory tract; reproductive tract; systemic; and eye, ear, nose and throat in the past five years; zero catheter-associated bloodstream or urinary tract infections for two years; and zero pneumonia infections for four years.

In addition, Penn Highlands Clearfield was one of the 117 Pennsylvania hospitals that achieved an employee influenza vaccination rate of 90 percent or better. Penn Highlands Clearfield scored a 93 percent.

Civiello credited the hospital’s performance improvement team’s physicians, nurses and support staff for their emphasis on safe, high quality care.
“High quality care is the top priority for us, and even one healthcare-associated infection is one too many. We are proud of the progress we’ve made and will continue to build on our success in order to provide a superior standard of care for our patients,” she said.

Penn Highlands DuBois

At Penn Highlands DuBois, Sherry McKee, Director of Performance Improvement, said the focus continues to be on prevention of surgical site and device-related infections through the use of "bundles" of care.

McKee explained that a bundle of care is a group of evidence-based interventions that have been shown to reduce infections when used together. Central line infections and surgical site infections have been reduced through the use before and after care with chlorhexidine-containing cleansing cloths and skin prep pads to reduce the chance of contamination of the incision or insertion site.

Also, prior to surgery the use of an antibacterial ointment to the skin inside the nostrils for five days has led to reduced surgical site infections for cardiac and joint surgeries. The introduction of these two interventions has reduced central line infections to zero over the last four years and a very low surgical site infections for the major surgeries, McKee said.

“The most important practice that all healthcare workers can do is hand washing. We even ask patients to help us monitor for handwashing because we know this simple task is the key to preventing infections of all types,” McKee said.

Penn Highlands DuBois was also pleased that 93 percent of its employees received the influenza vaccination last year, McKee noted.

Penn Highlands Elk

Penn Highland Elk continues to demonstrate low rates of healthcare-associated infections than the average for Pennsylvania hospitals, according to Christine Garner, MSN Edu, RN, Director of Quality, Risk Management and Infection Control.

Penn Highlands Elk patients have experienced no health-associated infections in the following areas: central line associated blood stream infections; catheter-associated urinary tract infections; and surgical procedures such abdominal hysterectomy and hip surgery.

Garner credited the hard work and driven efforts of the entire healthcare team on improving patient outcomes throughout the organization.

“Everyone in the organization has been very instrumental in the performance improvement initiatives to reduce and eliminate healthcare-associated infections at Penn Highlands Elk. Our goal is to hardwire excellence throughout our organization, which creates a higher level of quality care with positive outcomes and patient experience at a lower cost,” she stated.

Another area that is an important indicator and measure of facility’s commitment to patient safety is the influenza vaccination among healthcare providers. Garner stated that Penn Highlands Elk’s employee 2014-2015 seasonal influenza vaccinate rate was 95 percent.