'Reducing Infections In A Group Of Eastern Massachusetts Hospitals' by Jennifer Daley, M.D.

Editor's note: this is the 3rd of 3 posts on goals outlined by the Eastern Massachusetts Healthcare Initiative (EMHI), a group of major hospitals, health insurers and universities in Greater Boston.

As part of the Eastern Massachusetts Healthcare Initiative (EMHI), we established a Task Force of infection control chiefs and practitioners from each of our member hospitals to examine areas where hospitals were working on implementing effective prevention efforts to reduce healthcare associated infections (HAIs).

This Task Force includes at least one representative from all of our member hospitals: Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Children’s Hospital Boston, Dana Farber Cancer Institute, Lahey Clinic, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Tufts Medical Center and Winchester Hospital. Until recently, the Task Force was chaired by Dr. David Blumenthal of Massachusetts General Hospital and Partners Healthcare.

The group began its work by identifying “stuck points” - where the hospitals were encountering particular barriers to prevention initiatives in the following priority areas: hand hygiene, Methicillin-resistant Staphylococcus aureus (MRSA), central-line associated bloodstream infection (CLA-BSI), surgical site infection (SSI), and ventilator-associated pneumonia (VAP). These “stuck points”, or areas of difficulty, were then addressed in the development of best practices focusing on the importance of effective strategies in the areas of management and measurement. While all of our member hospitals have implemented some of the best practices, Task Force members believe they are all important enough to strive for full implementation. The hospitals are now developing work plans to track that implementation.

When Dr. Blumenthal moved on to his current role as National Coordinator of Health Information Technology for the Obama administration, I took over as Chair of the Task Force. In my role, I hope to serve as an effective facilitator and assist the group in moving forward in this important area.

The Task Force will continue to work together to share lessons learned and collaborate on improvement initiatives. One area is worth particular note. At a meeting in April, the EMHI Executive Committee, made up of the CEOs of all the EMHI organizations, committed to a leadership statement on infections, including the following language: “Each EMHI hospital commits to measurement, collective reporting, and reduction of preventable hospital-acquired infections (HAI) in order to eliminate them by 2014.”

A big part of this commitment will be the next steps on collective reporting. The CEOs have asked us to find a way to track infection rates for certain measures, and to report publicly on the collective progress of EMHI hospitals in aggregate periodically. The Task Force is currently exploring which measures to focus on in this area. One attractive possibility is to use the measures the state is currently requiring hospitals to report on a confidential basis to the Betsy Lehman Center for Patient Safety and Medical Error Reduction. This would give our hospitals the opportunity to highlight progress in those areas, and to position them well for when and if the state moves those measures to the public reporting category.

Jennifer Daley is Chief Medical Officer at Partners Community Healthcare, Inc. and Chair of the Eastern Massachusetts Healthcare Initiative Task Force on Eliminating Hospital-Associated Infections