Hospitals are continuing to improve patient care, per results from the second round of the American Hospital Association/Health Research & Educational Trust (HRET) Hospital Engagement Network (HEN), part of the CMS’ Partnership for Patients initiative.
The AHA/HRET HEN initiative involved more than 1,500 hospitals seeking to improve care across 11 areas, including prevention of hospital infections, falls, early elective maternal deliveries, and preventable readmissions. Among other findings, the AHA/HRET HEN 2.0 helped hospitals reduce early elective deliveries by 44%, postoperative venous thromboembolisms by 34%, and surgical site infections by 21% over the past year, preventing more than 34,000 incidents with an associated cost savings of nearly $300 million.
The project yielded many resources that are available for any hospital to use for free. The overall goal of the Partnership for Patients program was to reduce hospital-acquired conditions by 40% and readmissions by 20%.
HENs find best practices that reduce hospital-acquired conditions and share them with other providers, explains Charisse Coulombe, MS, MBA, CPHQ, HRET’s vice president for clinical quality. The HEN 2.0 project built upon the success of the initial HEN project, which prevented more than 92,000 hospital-acquired conditions and saved nearly $1 billion in avoided healthcare costs over a three-year period from January 2012 through November 2014.
The original HEN project lasted three years, and HEN 2.0 was one year. A large part of the project involved putting clinicians together to discuss the topics and compare strategies, Coulombe says.
“There is no one answer for how to reduce harm. It’s very specific to each hospital and community,” Coulombe says. “We provide them with multiple tools and resources, almost a one-stop shop where they can go for information about adverse drug events, for instance. That information might include advice on how engage pharmacists in that discussion, and how to engage physicians and hospital leadership.”
The AHA/HRET HEN 2.0 relied on five core strategies to assist hospitals. It distributed evidence, tools, and best practices to the field; offered coaching and technical assistance; spurred on peer-to-peer sharing; fostered increased capability and capacity in quality improvement; and deployed cross-cutting strategies.
Throughout the course of the project, AHA/HRET HEN 2.0 hospitals have prevented over 34,000 harms and have saved nearly $300 million in healthcare costs, Coulombe says. The AHA/HRET HEN 2.0 team supported hospitals across 34 states through hosting virtual and in-person educational events, maintaining a website with hundreds of resources and tools, providing intensive training to over 900 hospital staff who participated in Action Leader Fellowship and maintaining a database of nearly 400,000 data points collected to track and trend the improvement of patient care of all applicable topics for all hospitals.
AHA/HRET HEN 2.0 worked to prevent harm in 11 adverse event areas:
- Adverse Drug Events (ADE),
- Catheter Associated Urinary Tract Infections (CAUTI),
- Central Line Associated Bloodstream Infections (CLABSI),
- Falls With Injury,
- Pressure Ulcers (PrU),
- OB Harm,
- Early Elective Delivery (EED,)
- Surgical Site Infections (SSI),
- Venous Thromboembolisms (VTE), and
- Ventilator Associated Events (VAE).
Additionally, the AHA/HRET HEN 2.0 hospitals focused on sepsis and C. difficile, airway safety, culture of safety, failure to rescue, iatrogenic delirium, undue exposure to radiation, severe sepsis, and septic shock.
Hospitals interested in the AHA/HRET HEN 2.0 resources should start by assessing their own data to identify issues that might be addressed, Coulombe says. If falls are a problem, for instance, the hospital quality director can go to the project site and find many strategies and tools that could be applied, along with information on the experiences of other hospitals addressing the same problem, she says.
“The information should help the quality director ask the right questions and you’ll get a sense of what has worked in the past, and what hasn’t worked,” Coulombe says. “There’s a whole litany of information on each information, and the change package is the best place to start. Read all the ideas in there and you may see things you’ve tried in the past, but you’re almost certain to find new ideas that you can try.”
(The AHT/HRET HEN 2.0 final report is available online at
http://bit.ly/2fbrnrK. Free resources and more information on the project are available at http://www.hret-hen.org/.)