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Wednesday, August 24, 2011

Michigan VAP rates on steep decline

I wrote earlier how the Keystone Collaborative in Michigan has been so successful at improving patient outcomes and reducing costs that the Fed is recommending other states come up with a similar program.  New evidence shows that the Keystone Collaborative has helped to significantly lower the rates of ventilator acquired pneumonia (VAP) in Michigan Intensive Care Units.

The new study on at the U.S. Department of Health and Human Services, "Rates of Pneumonia Dramatically Reduced in Patients on Ventilators in Michigan Intensive Care Units," In fact, rates of VAP in Michigan hospitals has declined by 70 percent since the Keystone Collaborative was started.  The study included data from 112 ICUs in Michigan.

This is interesting considering I wrote this post about a presentation I gave about how Keystone Policies helped shoreline significantly reduce the rate of readmission rates for pneumonia patients.

The Keystone Collaborative is significant because it pools resources and wisdom from leaders from hospitals in Michigan and some surrounding states to decide what methodologies are needed to implement best practice medicine to improve outcome and reduce costs.  The Keystone Collaborative then recommends certain core measures for each hospital to try to achieve.

The Core Measures include measures that are proven to work for a specific diagnosis to speed the time from admission to discharge, reduce readmission rates, best practice medicine, and to make sure intensity of service is met in order to make sure the patient meets reimbursement criteria.

I have to note here that I'm not particularly happy that many redundant and unnecessary procedures are the result when hospitals resort to cook book medicine (which is what I think order sets are), in that it basically treats all patients the same.  Yet while this may be a side effect, the overall result for the hospital IS improved outcomes and reduced costs.

This recent study is proof again that that Michigan hospitals like Shoreline are taking steps in the right direction.  This is good for the patients, and it's good for RTs like you and me in that it helps to keep our hospitals financially sound so we can continue to get our paychecks.

The Keystone Committee at Shoreline has created order sets and some protocols that are aimed at accomplishing the core measures designed to implement best practice medicine, evidenced based therapies, prevent complications (like infections due to catheters being inserted too long and ventilators and central lines), and reduce the risk of patient's dying in the ICU.

When it comes to core measures, the study shows an increase from 32 percent to 84 percent in Michigan hospitals that have successfully implemented the core measures.  The study also showed a sharp decline in blood stream infections from central lines and has reduced the number of patients who die in the ICU (see sepsis protocol and extubation protocol).

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