Greater New York Hospital Foundation | Archived

Grant Date: 03.04.2005
Amount: $60,000

In February 2005, the United Hospital Fund awarded a $60,000 grant to the Greater New York Hospital Foundation to implement a regional hospital collaborative to improve the quality of care provided in intensive care units (ICUs) through the reduction of central line associated bloodstream (CLAB) infections.

Background

Improving care in the ICU is a major priority in health care quality improvement for two reasons. First, ICUs are the most expensive component of hospital care, accounting for 30 percent of acute care resources, or about $180 billion annually, with five million people being admitted to ICUs each year. In addition, central line associated bloodstream (CLABs) are one of the most common problems experienced by ICU patients. It is estimated that a CLABs can add $30,000-$70,000 per patient as a result in increased length of stay, need for additional treatments, ICU readmissions, and the development of other complications. Second, there is a growing body of work in other regions that have achieved dramatic reductions in CLABs in a short period of time. Thanks to the pioneering work of Johns Hopkins Hospital and others, we know that central line infections can be prevented through the use of standard care protocols. Hospitals using these methods have achieved major reductions in central line infections in a short period of time, but it is also clear from this experience that hospitals need technical resources and support in order to implement and sustain these practices.

Project Description

The Fund and GNYHA will jointly administer the regional ICU infection control hospital collaborative which will operate for a one-year period. Up to 20 participating hospitals will provide executive leadership and support, form one or more teams in each ICU, and implement a standard central line infection control model. Each hospital will also collect key process and outcomes data to determine whether and why central line infections have occurred, which will enable them to monitor their results and also use the data to support continuous improvement activities. The model and the data elements will be adapted from work conducted by Johns Hopkins Quality and Safety Center. The Fund and GNYHA will convene a project advisory committee to provide input on the project during the year. Technical assistance will be provided to participating hospitals through a variety of mechanisms including face-to-face meetings, teleconferences, webcasts, and on-site reviews. The project will also administer and analyze the results of a hospital survey designed to measure whether the organization has a strong “safety culture.” This will be an additional improvement tool for the hospitals, and at the end of the project UHF and GNYHA will ascertain whether there was any correlation between the hospitals' ICU infection control results and the results obtained from the “safety culture” survey. At the conclusion of the project, UHF and GNYHA will convene the participating hospitals to share their experience and determine whether this is a viable model to spread these types of improvement activities to other aspects of ICU care and other units within the hospital.