Prior Projects and Initiatives
CHA has participated in a variety of national and statewide projects and initiatives aimed at improving quality and patient safety measures among its member hospitals and health systems. For more information on prior projects and initiatives, contact CHA patient safety department at 720.330.6054
Below is a list of prior projects and initiatives CHA has participated in:
Antimicrobial Stewardship Program – Through this program, CHA committed to helping member hospitals and health systems form new antimicrobial stewardship programs or enhance existing ones. The focus of this program was proper prescribing of antimicrobials for Urinary Tract Infections (UTIs) and Skin and Soft Tissue Infections (SSTIs) with the dual goal of improving the accurate diagnosis of UTIs. CHA also sought to reduce the incidence of healthcare-associated Clostridium difficile infections (CDI). The overall purpose of this collaborative was to disseminate evidence and strategies for antimicrobial stewardship and to assist member hospitals in embedding those strategies in daily clinical practice. During this program, CHA produced the Acute Care Antimicrobial Stewardship Collaborative Report.
Boards on Board Initiative – In 2007, CHA led a campaign to educate hospital trustees and administrators regarding quality and patient safety improvement efforts throughout the hospital setting, and to encourage greater accountability in the board room for their execution. The Colorado Boards on Board initiative effectively created that culture shift by establishing system-wide accountability, whereby every person in the hospital—from board members to housekeeping staff—is charged with improving safety in their specific area of responsibility.
Clostridium difficile Infections Tool Kit – Clostridium difficile (C. diff or CDI) is a spore-forming, gram-positive bacterium that can cause antibiotic-associated diarrhea and more serious intestinal conditions such as colitis and even death. For each patient with a C. diff infection, an average 2.6-4.5 days is added to the length of stay, an additional $2,470-$3,669 in cost is added per episode and an additional $5,042-$7,179 is added to inpatient costs in the six months following diagnosis. CHA created a CDI Tool Kit as a component of the Infection Prevention Collaborative to provide resources and an overview of evidence-based practices related to the prevention of CDI in the health care environment. To view the tool kit, click here.
Colorado Alert Wristband Standardization – Many states are working towards standardization of color-coded alert wristbands in acute care hospitals. To address this patient safety issue in Colorado, CHA and the Colorado Foundation for Medical Care joined forces with the Western Region Alliance for Patient Safety, a multi-state regional collaborative, to standardize patient alert wristbands in hospitals. In an effort to reduce the financial burden that may be associated with this voluntary statewide standarization, CHA recommends phasing in the new colors over a 12-month period to provide enough time for staff education and use of out-of-date colored bands in hospital inventory. To access the tool kit, click here.
Colorado Surgical Site Checklist – The CHA Board of Trustees approved and endorsed the use of a uniform surgical site checklist for all Colorado hospitals. In early 2009, CHA partnered with the Colorado Medical Society and COPIC to tailor the World Health Organization’s Surgical Site Checklist to the specific needs of Colorado hospitals. The modified checklist was prepared in collaboration with physicians, quality professionals and surgical nurses, and includes additional safety “checks,” such as those required by The Joint Commission.
Elimination of Avoidable Harm – CHA is presently working with its member hospitals and health systems towards achieving zero incidences of avoidable harm by 2015. Members are being engaged on a variety of levels and are receiving technical assistance and support that responds to the unique needs of the individual facilities. As part of this project, CHA is focusing its efforts on reducing facility-acquired infections, avoidable readmissions and avoidable mortality.
Emergency Code Standardization Project – In addition to standardized wristbands, CHA worked with Colorado hospitals in 2008 to adopt standard overhead emergency codes for all hospitals. Like the wristband project, this helps to prevent confusion for caregivers who practice in multiple hospital settings.
Hospital Improvement and Innovation Network (HIIN) – The Partnership for Patients (PfP) Hospital Improvement and Innovation Network (HIIN) was a national initiative to prevent patient harm and improve care in hospitals across the U.S. The HIIN continued the successful work of Hospital Engagement Network (HEN), which saved more than 87,000 lives and $19.8 billion in health care costs over four years. Fifty-one Colorado hospitals participated in this important work. To learn more, click here.
Infection Prevention Collaborative – CHA was awarded a grant from the Colorado Department of Public Health and Environment in December 2009 to lead an infection prevention collaborative over a two-year period. The infection prevention collaborative focused on surgical site and Clostridium difficile infections. The infection prevention collaborative was a board-based initiative that involved acute care hospitals, long-term acute care hospitals, ambulatory surgical centers and dialysis centers.
Influenza Vaccination Tool Kit – The Centers for Disease Control and Prevention (CDC) recommends that health care personnel be vaccinated annually against influenza. On Feb. 15, 2012, the Colorado Board of Health passed a rule regarding influenza vaccinations for health care workers that includes influenza vaccination rate thresholds that health care facilities must achieve by certain dates (60 percent of all employees by the end of 2012; 75 percent by the end of 2013; and 90 percent by the end of 2014). Facilities meeting this and other rule requirements may be exempted from the data submission provision within the rule. Click here for a summary of the state rule, or click here for its full text. In May 2011, the CHA Board of Trustees passed a resolution urging health care facilities to vaccinate personnel against influenza. Vaccination of health care workers against influenza not only protects patients and their families, but also protects the valuable Colorado hospital workforce against illness. CHA also created an Influenza Vaccination Tool Kit to provide guidance and information for developing a mandatory influenza vaccination program within individual hospitals.
MRSA Prevention Project – In 2009, CHA launched the Infection Prevention Project to provide hospitals with the information they needed to implement successful infection prevention systems and to assist them in accurately reporting their infection data. As part of the project, CHA created and distributed a MRSA toolkit that provides Colorado hospitals with the opportunity to review specific infection control strategies and tailor processes to address the needs of their organization and patient population. Hospitals were also invited to a MRSA summit hosted by CHA.
On the CUSP: Stop BSI – In partnership with the Agency for Healthcare Research and Quality, the Health Research and Educational Trust and Johns Hopkins University, CHA helped Colorado hospitals implement a national initiative to reduce central line-associated blood stream infections (BSIs) in hospital intensive care settings. The Comprehensive Unit-Based Safety Program, known as On the CUSP, combines evidence-based protocols with patient safety culture assessment. The initiative began in 2010.
Project JOINTS (Joining Hospitals in Tackling Surgical Site Infections) – Project JOINTS was funded by the federal government to give participants support from the Institute of Healthcare Improvement (IHI) in the form of in-person and virtual coaching on how to test, implement, and spread the enhanced Surgical Site Infection (SSI) Prevention Bundle, which is comprised of the current Surgical Care Improvement Project components plus three new SSI prevention interventions. Colorado was selected as one of five states to participate in the original cohort.
Reducing Hospital Admissions
CHA and UnitedHealthcare partnered on a 24-month collaborative which aimed to reduce preventable readmissions. The collaborative was geared towards the widespread implementation of a reengineered hospital discharge process, Project RED (Re-Engineered Discharge). A total of 19 Colorado hospitals implemented the Project RED intervention with 7,679 patients. Participating hospitals reported a 30 percent relative reduction in the all-cause readmission rates, dropping from 13.3 percent to 9.3 percent, and a 43 percent relative reduction in same-cause readmission rates, dropping from 6.5 percent to 3.7 percent. CHA estimates this project saved approximately $2.6 million by averting 311 all-cause readmissions (including same-cause readmissions) over seven quarters of intervention across 19 hospitals. There was no statistical correlation found between the action steps and a reduction in readmissions. The collaborative saw notable improvement in compliance over the intervention period with step 1 and 4 (education on the patient’s diagnosis, including national guidelines and organizing post-discharge services), step 9 (assess the patient’s level of understanding, i.e., “teach-back”) and step 11 (contact the patient to reinforce discharge plan two to three days after discharge). The collaborative consistently showed high compliance with step 5 (confirm the medication plan) and step 10 (give the patient a written discharge plan at the time of discharge).
Safe Deliveries Colorado – Colorado Hospital Association (CHA) partnered with Anthem Blue Cross and Blue Shield Colorado, the March of Dimes Colorado/Wyoming Chapter and the Colorado Perinatal Care Quality Collaborative to create the Safe Deliveries Colorado collaborative. Nineteen Colorado hospitals participated in the collaborative, along with OB and family practice health care providers from across the state. Click here to learn more.
Surgical Site Infections Tool Kit – A surgical site infection (SSI) is defined as an infection that occurs following surgery at the site in the body where surgery was performed. Each SSI has an average attributable cost ranging from $3,000-$29,000 depending on the type of infecting agent and the surgical procedure performed. As part of the Infection Prevention Collaborative, CHA developed a SSI Tool Kit to provide resources and an overview of evidence-based practices related to the prevention of SSIs in hospitals and ambulatory surgical centers. To view the tool kit, click here.