Parkland Health & Hospital Systems
Parkland claims success in preventing hospital-associated infections
Leaders of Dallas County’s public hospital claimed “early successes” Wednesday in a four-year effort to prevent hospital-associated infections among its patients.
Such infections “are a major concern for every hospital,” said Dr. Fred Cerise, president and chief executive officer of Parkland Health & Hospital System. “And while Parkland’s rates of [hospital-associated infections] place us in good standing compared to national benchmarks, we are continually focused on this issue.”
A statement released by the hospital concluded that “Parkland has already begun to see early successes” in an initiative, called Reduce Infections Together in Everybody. It was launched in 2013 and is being funded by Medicaid through the state’s 1115 Waiver program.
“Our goal is to accelerate improvements and achieve much-needed standardization in knowledge, attitudes, practices and cultures of safety related to these potentially preventable complications,” said Dr. Pranavi Sreeramoju, chief of infection prevention at Parkland.
The effort is focusing on three types of infections: central line-associated bloodstream infections, catheter-associated urinary tract infections and surgical-site infections that leads to sepsis, or wound infections, Sreeramoju said.
In 2014, Parkland saw improvement in all three areas, including a 30 percent reduction in the rate of bloodstream infections, 57 percent fewer catheter-associated infections and an 18 percent fall in sepsis. It also nearly doubled the number of patients getting sepsis care within hours of their arrival at the hospital.
Parkland’s medical staff has been trained to identify how these infections typically occur as well as potential solutions. The hospital also is training more staff members in infection control and is taking part in a regional collaboration to share these practices, Sreeramoju said.
The Centers for Disease Control and Prevention reports that about one in 25 patients hospitalized in the U.S. develops an infection associated with their hospital care. About 722,000 healthcare associated infections are reported each year and are linked to as many as 75,000 deaths in the U.S. The cost of treating such infections is also enormous, accounting for an estimated $28 billion to $33 billion in excess health care costs annually, according to the U.S. Department of Health & Human Services.
“We are pleased with these results, but there are many more things to do,” Sreeramoju concluded. “It will continue as an integral part of Parkland’s commitment to continuous quality improvement and transformation of health care delivery.”
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TAMU Baylor College of Dentistry
Baylor College of Dentistry’s 3-Year DSRIP project expands services to low-income, dentally underserved people through co-location within Healing Hands Ministry, a community medical clinic. The clinic, staffed by 4 senior dental students under the supervision of BCD faculty, will also expand BCD’s community-based clinical training program. Previously, Healing Hands Ministry offered dental care 4-16 hours a month through volunteer dentists. Now with DSRIP funding Baylor College of Dentistry is providing 160 hours of dental services a month to 480 patients. Services include oral health, cleanings, fillings, and extractions. Digital radiography is provided onsite. Patients are referred to the dental clinic through the Healing Hands Ministry medical clinic. An additional collaboration is established with THR-Dallas to refer patients to the clinic who present in their ED with dental pain. Patients go to the ED because they have no other place to go.
Senior dental resident Lindsay Pigg shared a story of a grandma who moved to the U.S. after fleeing turmoil in Africa. She had never seen a dentist before and was living with chronic dental pain. “The grandmother was so happy she couldn’t stop hugging us! We were her only option for care.”
Future plans for the dental clinic include expanding services (offering partials, dentures, and crowns), adding a compressor/vacuum pump, an additional 2 chairs, implementing an EMR, and adding pediatric residents.
“The collaboration has been incredible. It’s such a positive impact for the community to be able to provide medical and dental services in 1 location. The clinic is near an area where a high number of refugees have settled. They do not have the means to pay for expensive care,” states Janna Gardner, President and CEO of Healing Hands Ministry.
Another patient, M.S., cannot afford insurance for himself and his wife. He’s a patient at the dental clinic and has been seen 5 times for restorative work. “It’s important to me to keep my teeth healthy. Coming to this clinic helps me achieve it”.
UT Southwestern
UT Southwestern (UTSW) Clinical Park Cities and North Dallas Shared Ministries (NDSM) are expanding an existing point of access to the uninsured/uninsured population in Dallas. The partnership aims to bridge identified gaps in care while providing shared medical appointments and evidence-based medicine to our patients in Dallas County. The DSRIP project is expanding resources for mammography referral and rapid reporting of mammograms. In the past a patient may have to wait months for a mobile mammogram unit to come to their neighborhood. Now mammograms are done within 2 weeks of a referral and results are received in less than 48 hours.
Baylor Scott & White
In June, Baylor Scott & White opened a new primary care clinic in Carrollton. The clinic is part of the Primary Care Expansion DSRIP project at Baylor Carrollton. There are few primary care resources available for the underserved in the area. Specialty care and chronic disease programs will be offered as well. Currently the clinic is staffed with 1 physician, 1 MA and 1 RN with the potential to hire a part time NP if necessary. The clinic will bring the patient-centered medical home model to underserved patients in the Carrollton community and allow for continuity of care and ED diversion. Already 86 new patients have been enrolled and 173 encounters performed to date and demand continues to grow.
Patient Care Management
Parkland Health & Hospital System
Recognizing the need for additional support for patients with a mental disorder, Parkland Health and Hospital System implemented a peer navigation program. Through care coordination and focused individual support, assistance is provided to this vulnerable population to decrease unnecessary ED visits, increase access to care, enhance self-management skills, as well as increase satisfaction for the patient and family.
One patient example, BB presented to the emergency room for narcotics withdrawal. She was recognized to be a high risk behavioral health/substance abuse patient and a social worker placed a peer navigator referral. The Peer Navigation program was explained to BB and she decided to enroll in the program. She had several questions for the peer navigator and support was provided regarding groups and transportation near her location. BB called her assigned peer navigator requesting additional information on a local Narcotics Anonymous group and to date has had 6 contacts with her peer navigator. BB has been sober for two months. She has completed all of her paperwork for Metrocare, is compliant with her court ordered meetings, and has been able to reestablish custody of her son. The project currently has 261 patients enrolled.