Billings Clinic has reduced by 60 percent its overall rate of potentially deadly MRSA infections, one of the most common, costly and difficult-to-beat hospital-acquired infections. The clinic is being used as an example to other hospitals battling the issue, according to the Washington, D.C.-based not-for-profit Plexus Institute.
“Everyone has been working on this problem six ways from Sunday, but the rates of infection kept going up,” said Lisa Kimball, president of Plexus. “Billings Clinic has been incredibly creative in pioneering a method that has proven highly effective. We are now using Billings Clinic as an example to other hospitals in the nation.”
MRSA, the commonly known name for methicillin-resistant Staphylococcus aureus, is a bacterium that is resistant to antibiotics in the penicillin family, the ones usually prescribed to treat bacterial infections. If untreated or treated improperly, it can kill human tissue and damage internal organs. About 19,000 Americans die annually from MRSA infections, according to the CDC.
Reducing infection rates plays a significant role in controlling the rising cost of health care. The average extra cost to a hospital for treating a patient who becomes infected with MRSA is $27,000, adding $10 billion a year to the country’s health care bill, according to Plexus.
Billings Clinic employees have been working for nearly five years to change behavior and create innovative programs that have a lasting impact on curbing the infection.
“We are humbled,” said Nancy Iversen, a registered nurse and director of safety and infection control at Billings Clinic. “We’ve created an environment that is safer for patients.”
The hospital engaged front-line employees, those who interact with patients and are likely to be affected by MRSA, asking them how best to address the problem. The efforts were aimed at changing the hospital’s culture and everyday behavior. Employees, for example, are encouraged to call out a colleague for violating safety guidelines.
Most people know the way to reduce infection requires taking precautions such as wearing gloves and washing your hands. But in the hectic and overworked world of today’s hospitals, staff members often fail to take these necessary steps even when they are aware of the dangers, Kimball said.
“Knowledge doesn’t change behavior, but practice does,” Kimball said.
In fact, as she points out, most health care institutions have systems in place that work against effective precautions. In one institution, for example, it turned out that glove supplies were on a different floor from the nurses and staff members.
Plexus has found Billings Clinic’s work so impressive that its efforts have been included in a new book, “Inviting Everyone: Healing Healthcare Through Positive Deviance.”
An excerpt from the book says, “At Billings Clinic’s 272-bed hospital, health care-associated MRSA infections declined 80 percent house-wide since the Positive Deviance effort began in late 2006. The number of MRSA infections in the intensive care unit, which served as the PD pilot unit, has dropped to almost zero. In 2005 and 2006 there were 28 total health care-associated MRSA infections. In the more than three years since then there have been four.”
Iversen said that while the rates of infection dropped during the study, Billings Clinic has been able to maintain and even improve the rates. The hospital has logged two infection cases in its ICU unit since January 2008. To date this year, it has recorded one in the overall hospital population.
In addition to Billings Clinic, participating hospitals in the study were Albert Einstein Medical Center in Philadelphia, Johns Hopkins Hospital in Baltimore, Franklin Square Hospital Center in Baltimore, University of Louisville Hospital in Kentucky, and the VA Pittsburgh Healthcare System.
The three-year study, conducted from 2006 to 2008, was made possible with the help of a $300,000 grant from the Robert Woods Johnson Foundation. Participants had to compete for a coveted spot in the study. Collectively, the hospitals reduced their rate by 65 to 70 percent.