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One Change, 9,000 Lives
Date: October 28, 2011
By Bill Fortenberry
Ask Dr. Darrell Dean about a medical issue or a way to de-stress, and he will speak to you with the quiet wisdom of shaman. Ask him about hospital-associated infections, and his eyes focus, his posture grows more rigid, and the wealth of information he holds is unleashed in new energy.
He quotes the statistics like a minister quotes the Bible:
- Hospital-acquired infections are one of the top ten leading causes of death in the U.S.
- Approximately 1.2 million hospital patients are infected with dangerous, drug-resistant staph infections each year.
- One in 20 patients–about two million a year–contract an infection while in the hospital.
- Hospital-acquired infections kill over 90,000 people annually – more than motor vehicle accidents, breast cancer, or AIDS.
- Hospital-acquired infections increase the length of hospital stays up to 30 days.
- The cost to the U.S. health system of treating hospitalized patients with staph infections is as high as $4.2 billion annually.
A Better Catheter Kit
As Medical Director for Performance Improvement at Floyd, Dr. Dean doesn’t let those statistics intimidate him. Instead, they are his adrenaline, spurring him to take action and innovation.
Several months ago Dr. Dean met with Medline, the vendor who supplies Floyd with Foley catheters. As the conversation turned to urinary tract infections that can be traced to catheters, Dr. Dean told the vendor that part of the problem was the kit itself.
He pointed out failures in the design of the Foley Catheter kits that could actually contribute negatively to infection rates, then explained that there was a better way.
It didn’t take long before Dr. Dean was in touch with the company executives responsible for the design of these kits, and not long after that, the kits were changed to meet Dr. Dean’s specifications. They are now in use in hospitals across the country.
Not long afterwards, he was a featured speaker at a national conference, telling others how to make the changes Floyd has made to eliminate these infections from our critical care areas–a change that, according to the Centers for Disease Control and Prevention, could save 9,000 lives annually.
Those 9,000 patients likely will never know the name of Dr. Darrell Dean, because they won’t get the infection that might have caused them to learn about him. They’ll go home healthy, happy and none the wiser.
One change. 9,000 patient lives. If success can be measured, this may well be Dr. Dean’s equation, but there are others.
Diabetes Care
In addition to reducing catheter associated urinary tract infections, he has been instrumental in improving our diabetes care.
Dr. Dean wrote and revised order sets for patients with diabetes. He followed up by providing physician and staff education about diabetes, bringing world-renown experts to Floyd to instruct our clinical staff. This improved care has the potential to touch each one of the 6,000 patients with diabetes who are hospitalized each year at Floyd.
Dr. Dean led our effort to reduce ventilator-associated pneumonias and central line-associated infections. Dr. Dean works closely with our Infection Prevention department on strict hand hygiene maintenance and adhesion to contact precautions and sterile technique.
Last year alone, his efforts to reduce infections prevented 10 deaths from sepsis.
He also is instrumental in the establishment of our rapid response teams. Comprised of a family medicine resident, critical care nurse and respiratory therapist, these teams are available around the clock to respond to patients whose conditions have significantly declined.
The team evaluates and stabilizes the patient and determines whether critical care is needed. These efforts prevented another 135 deaths at Floyd.
Core Measures
Dr. Dean is a champion of Medicare’s Core Measures for patient care. Dr. Dean believes the way to ensure all patients get the appropriate care is to make it difficult, if not impossible, for clinicians to miss providing those measures.
To assist in that effort, he has designed order sets that include core measures, and he was involved in the design of the core measures dashboards in our electronic medical records system. He meets with physicians individually to explain the measures and to enlist their support in achieving “perfect care.”
He is passionate about patient safety, and the results are measurable. These changes will save or improve the lives of over 15,000 patients annually. One year, 15,000 lives. That is care that makes a difference.
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