The pediatric intensive care unit (PICU) and the Jonathan Jaques Children’s Cancer Center at Miller Children’s Hospital Long Beach have been participating in a five-year quality improvement initiative starting with the National Association of Children’s Hospitals and Related Institutions (NACHRI) to eradicate central line-associated blood stream infections (CLABSI) in their unit. In collaboration with more than 80 other children’s hospitals nationwide, NACHRI’s Quality Transformation Network (QTN), which Miller Children’s is a part of, has saved 355 children’s lives, prevented 2,964 central line infections and passed the $100 million mark for total cost savings.
Most recently, the PICU at Miller Children’s has made excellent strides in infection control. The unit had only one catheter associated urinary tract infection (CAUTI) since January 2010 and has gone 11 months without a single hospital-acquired infection. The PICU has consistently met the National Health Safety Network target for infection prevention and when compared with other nationwide PICUs, Miller Children’s is in the top 10 percentile for preventing catheter associated blood stream infections, CAUTIs and ventilator associated pneumonias. Since December 2009, the PICU has been able to prevent twelve infections, including one death and has saved more than $420,000.
“The NACHRI collaborative has had numerous positive effects, especially within our hematology/oncology population where their central venous access is an invaluable lifeline to disease-altering therapies,” says Erin Felkel, clinical educator of pediatric hematology/oncology and pediatric specialty units. “One can measure the number of infection free days, or the cost saving with reduced hospital days, however it is the unquantifiable markers that our families could mention that are just as important.” From the more than 30 hematology/oncology units in the NACHRI collaborative, the group of hospitals has been able to prevent sixteen deaths and a cost savings of more than $4 million.
“NACHRI congratulates Miller Children’s Hospital Long Beach on this well-timed milestone,” said Lawrence McAndrews, president and CEO of NACHRI. “Together children’s hospitals have successfully eliminated $100 million in preventable hospital costs at a time when legislators are making decisions about critical health care funding. Children’s hospitals are demonstrating that they are leaders in pioneering quality improvement solutions that not only save money but most importantly save lives.”
CLABSIs are infections that occur in patients’ central venous catheters (a central line is flexible medical tubing inserted into the body). They are also a preventable harm that carries a price tag of at least $25,000-$45,000 per event and a 10 to 20 percent mortality risk for children.
“As the NACHRI QTN enters its sixth year, our faculty and clinical teams in children’s hospitals are continually pushing to improve care for our patients,” said NACHRI Quality Transformation Vice President, Marlene Miller, M.D., MSC. “Because the pediatric community is small and nimble, we can spread proven practice opportunities more rapidly, providing better quality care for children at lower overall costs.” With 162 units from 88 hospitals, 40 percent of NACHRI’s 220 member hospitals have participated to date in this national effort to eradicate pediatric CLABSIs as well as other health care associated infections.