Quality and Patient Safety

Ensuring Quality and Safe Experiences

Quality and patient safety are top priority at Ochsner Health. At Ochsner, we use proven strategies and follow detailed checklists to improve quality and ensure you and your loved ones have safe experiences in our hospitals and clinics.

At Ochsner, we call patient safety “Target Zero.’’ Target Zero means we work diligently to hit zero on several patient safety measures:

1. Pressure injuries, also known as bedsores
2. Infections
3. Procedures on the wrong side of the body and objects left behind during operations
4. Patient falls

You can find and compare hospital quality of care data on the Medicare website.

Pressure injuries

Pressure injuries are also known as bedsores, pressure ulcers and pressure sores. “Decubitus ulcers” is a term that doctors use to describe this type of injury.

We know that people who are elderly and people who spend a lot of time in bed are most at risk for bedsores. At Ochsner, care teams frequently help patients turn in bed or make other small adjustments so that pressure is reduced on any one area of the body. Our care teams also strive to keep each patient’s skin dry and clean. Hospital staff members keep a close eye on the patient’s skin, and if they have concerns, they alert our wound care experts.

Ochsner even has a dedicated work group whose mission is to improve skin and wound care. The system workgroup focuses on reducing severe pressure injuries. Ochsner also has a system Wound Care integration Council.

Hospital-acquired infections

Hospital-acquired infections are infections that people can get while they are staying in the hospital.

One type of infection that Ochsner works to prevent is called a “central line associated blood stream infection.’’ Medical professionals also refer to this infection by its abbreviation, CLABSI.

A central line is a large IV or tube that is placed into a patient’s large vein, usually in the neck, chest, arm or groin. It is often used to draw blood or give fluids or medications. A central line associated bloodstream infection is the term for an infection that can occur when bacteria or other germs travel through the central line and enter the blood.

Ochsner follows proven ways to help prevent these infections. One way is to remove the central line as soon as a doctor says it is safe to do so. Other ways include using specific coverings or dressings over the spot where the catheter enters the skin. At Ochsner, we make sure to note how long a central line has been in place so that doctors and nurses can easily find that information.

Another type of infection we work hard to prevent is called a “catheter associated urinary tract infection.’’ Medical professionals frequently refer to this infection by its abbreviation, CAUTI.

An “indwelling urinary catheter,” or a “Foley” catheter, is a thin, flexible tube that is placed in a patient’s bladder to drain urine. Foleys are used temporarily when a patient is incapacitated, such as during surgery or when they are unable to urinate on their own. Catheters can also be used long term for patients with ongoing urological conditions. According to the Centers for Disease Control between 15%-25% of all hospitalized patients receive urinary catheters during their hospital stay. A catheter associated urinary tract infection can occur when bacteria or other germs travel down the tubing and enter the urine.

At Ochsner, we have developed a dashboard to monitor how we are using these catheters to help us reduce infections.

Another type of infection we work to reduce is called “methicillin-resistant Staphylococcus aureus,’’ or MRSA.

This is a type of bacteria that is resistant to several antibiotics. It can be found in the community and in the hospital. About 2 in every 100 people carry this type of bacteria. Most of those carriers, who are “colonized” with MRSA, do not develop serious infections. However, the CDC has named MRSA a “serious threat” to public health because it is resistant to antibiotics. In the community, MRSA most often causes skin infections. In some cases, it causes pneumonia (lung infection) and other infections. If left untreated, MRSA infections can become severe and cause sepsis, which is a serious illness.

At Ochsner, we follow protocols to routinely collect blood from hospitalized patients to test for this bacteria.

Another type of infection we work to prevent is “Clostridioides difficile,’’ which medical professionals often refer to as C.diff.

C. diff is a bacterium that causes severe diarrhea and colitis (an inflammation of the colon). Outside of the body, C. diff forms spores that are hard to kill and easy to spread from person to person, surface to surface, and surface to person. Alcohol-based disinfectants and hand sanitizer cannot penetrate C. diff spores, so it is essential to wash hands with soap and water, and clean patient rooms and equipment with bleach when patients are suspected or confirmed to have C. diff.

Wrong-sided procedures and objects left behind

We’re always thinking of ways to make Ochsner the best place to receive safe, high-quality care. One way we do that in our operating rooms is by using our Safe Surgical Checklist. Ochsner works hard to make sure procedures are not performed on the wrong side of the body. We also diligently work toward preventing foreign objects being left inside a patient’s body after a procedure.

The Louisiana Surgical Quality Collaborative states that using such a checklist has been proven to help reduce operating room complications, save lives and improve efficiency.

For years, we’ve been conducting surgical “time-outs” to ensure we don’t forget some basic things before we start the procedure. Checklists are designed to prevent errors from happening. The checklist also helps make sure that everyone follows the same process.

We work hard to prevent objects from remaining in the patient’s body after a procedure. We use a lot of things in procedures: sponges, instruments and more. In many surgeries, it’s not unusual to use 50 or more sponges.

To prevent items from being left behind, we make sure that more than one person is monitoring which items have been used during the procedure. We follow a detailed process to make mistakes less likely, which includes counting how many items go in and how many items go out after the surgery.

The Surgicount system, used in all Ochsner hospitals, is especially effective. This system uses sponges with special tags. A medical professional can detect these sponges by waving a special wand over the area after the operation is complete. This system has helped us reduce the number of sponges left behind significantly.

Patient falls

As part of the ongoing quality improvement and safety initiatives at Ochsner Health, fall rates and fall prevention measures are counted and tracked. As falls are tracked and reported, Ochsner analyzes these occurrences and implements fall prevention programs to reduce  occurrences.

Conclusion

Ochsner is dedicated to continuous improvements in patient safety, working toward “Target Zero’’ in pressure injuries (bedsores), infections, wrong-sided procedures and falls. Ochsner will continue to use leading strategies and comprehensive checklists to make a hospital stay as safe as possible for you and your family.

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