Since implementing new Expanse workflows and tools in early 2022, Southern Ohio Medical Center (Portsmouth, OH) has seen a 30% relative change in hospital-acquired infection of C. difficile and a 32% relative change in canceled tests.
These impressive results were driven by a collaborative effort between SOMC’s Quality Improvement Team and MEDITECH Professional Services (MPS) to advance evidence-based care, improve patient outcomes, and streamline the inefficient testing processes that were consuming the staff’s time.
“We are always looking for better ways to provide care,” said SOMC Vice President of Clinical Integration and Chief Quality Officer Valerie DeCamp, DNP, RN, A-GNP-C, NE-BC. “Our performance model is called A Better Way and our team, in partnership with MEDITECH Professional Services, did just that. We found a better way to detect C. difficile infections and provide patient treatment earlier on.”
Previously, SOMC’s manual process of C. difficile testing consumed an unnecessary 3.5 staff hours per week and resulted in numerous canceled tests, wasted supplies, and testing turnaround delays. By working with MPS to redesign workflows, improve documentation, incorporate real-time surveillance monitoring and alerts, and embed evidence-based clinical decision support into Expanse, they are now able to determine the risk of C. difficile and automatically trigger orders when appropriate. These changes have led to earlier detection, isolation, and treatment of patients with C. difficile, which have helped to improve patient outcomes, increased care team awareness, and helped to prevent community spread.
“Collaboration between our internal team and MEDITECH Professional Services has helped us to set clear goals and develop a structured path forward,” said SOMC Senior Medical Infectious Disease Director Dr. David Byers. “We believe a significant part of our success was the extensive MEDITECH knowledge that the MPS team brought to the table. They helped us take our concept and build something that has greatly impacted our organization.”
MPS, in collaboration with SOMC designed robust Business and Clinical Analytics reports to measure the impact of the C. difficile reduction efforts and identify areas of further need. Their 32% reduction in canceled tests has resulted in time savings of:
3.5 hours of pharmacist time per week, previously spent reviewing all C. difficile orders
3-5 minutes per specimen of time documenting test cancelation and cancelation reasoning within the patient chart
5 minutes per test in the lab and a significant reduction in testing result delays
Time saved collecting unnecessary specimens.
SOMC’s 30% relative change in hospital-acquired C. difficile is part of the organization’s continued efforts to maintain high quality metrics on a publicly reported measure; leading to higher consumer confidence, while allowing SOMC to avoid penalties based on value based payment models. This initiative has also helped their antimicrobial stewardship efforts by optimizing antibiotic prescribing practices.
“In addition to the mortality attributed to C.difficile, the morbidity cannot be overstated,” said Byers. “This is a disease that I have seen upend the lives of previously healthy patients through multiple relapses or even colectomies, and often precipitated by antibiotics they didn’t need.”
MEDITECH Senior Vice President Hoda Sayed-Friel believes that focusing on the prevention of hospital-acquired infections is an important strategy for improving the experiences of both patients and providers.
“Southern Ohio Medical Center’s commitment to quality improvement really is an investment in their future,” she said. “Already they are making a huge impact on their community by improving patient outcomes and reducing staff burdens by maximizing the potential of their Expanse EHR. We are excited that Expanse and MEDITECH Professional Services are able to support them on their journey.”
Moving forward, SOMC looks to leverage the work they completed with MPS as a foundational proof of concept to be applied to other desired targets for diagnostic stewardship.
To learn more about Southern Ohio Medical Center’s quality improvement efforts, please read their blog post, “Serving your community with a quality strategy” and listen to Dr. Byers on This Week Health’s TownHall podcast.
Video duration: 1 min. 41 sec.
