Outbreak equals opportunity

It’s the things that go wrong in the health system that often preoccupy us.

While we frequently look for big answers, it is often in the everyday efforts that real change is taking place.

In the past we have seen some hospitals react to funding restraint by simply hacking off clinics or beds, as if they were sawing off a piece of sausage.

Many more have been undergoing process changes that appear to be paying off in both savings and quality of care. This story is just one of many.

Recently Lakeridge Health won an international award for its efforts to reduce incidents of hospital acquired C-Difficile.

Rather than cutting off another piece of the sausage, Lakeridge actually added a second pharmacist to its now three-member anti-microbial stewardship team. That investment is paying off.

Faced with 84 cases of C-Difficile last year, Lakeridge was determined to get that number down permanently. C-difficile is life altering for those who get it. It is also very costly for hospitals to treat.

Almost all cases of C-Difficile are connected to patients who have recently taken an antibiotic. Antibiotics can alter the balance between good and bad bacteria in a patient’s bowels, leading to symptoms including watery diarrhea, fever, nausea and stomach pain. For a small number of patients, C-Difficile can be life threatening.

Lakeridge’s infection control staff believe too few people understand the risks involved in taking antibiotics.

“Our wish is to have the Ministry do a commercial on it,” Judy McCarten told the Central East LHIN board on Wednesday. McCarten is an infection control specialist at Lakeridge.

Lakeridge set out to reduce use of antibiotics that are most frequently associated with C-Difficile as well as encouraging doctors to think twice about the duration of the prescription or the need for it at all. That has led to a 35 per cent reduction in the use of antibiotics at the hospital.

The hospital is also improving screening, noting new tests are more sensitive to picking up the infection.

It also stepped up prevention efforts, encouraging not just staff to wash their hands frequently, but visitors too.

Clinical leaders were given C-difficile checklists, which include staff safety huddles during shift change.

The extensive toolkit Lakeridge developed was successful in dramatically reducing rates of C-difficile at the hospital. They argue the change is permanent.

“Not many hospitals have been able to sustain change,” Dr. Dan Ricciuto told the LHIN. The Lakeridge team believe that have it beat and are sharing their toolkit with others, including the region’s long-term care homes. This year Lakeridge is experiencing half the rate of C-Difficile of 2012 and the hospital is no longer in outbreak.

“Outbreak equals opportunity,” McCarten told the LHIN.