Hospitalized patients are at higher risk for complications such as falls, pressure ulcers, health care-associated infections and hospital readmissions. Lahey Hospital & Medical Center's staff stays informed about best practices for preventing these complications and seeks to continuously improve on our outcomes.

We report data  related to hospital patients to the Centers for Medicare and Medicaid Services and to other partnering organizations, such as Patient CareLink, a statewide initiative that collects data on nursing-sensitive indicators. Read more about these issues below.
 

Falls | Pressure Ulcers | Health Care-Associated Infections |
Hospital Readmissions
 

Falls

According to Patient CareLink, falls represent the most common reported event and the second most common cause of harm in hospitals. The severity of a fall depends a great deal on the circumstances and the condition of the patient prior to the fall. Falls that result in injury can lead to longer lengths of stay, additional interventions and, in the most extreme cases, lasting disability.

Recognized measures to prevent falls include assessing fall risk upon admission and reassessing the risk regularly during a hospital stay; educating patients about the need to request assistance when necessary; and making sure call bells are easy to reach and pathways are clear.

Preventing falls is a major focus of quality improvement efforts at Lahey Hospital & Medical Center. A falls committee meets regularly to address fall risks and create additional strategies to eliminate them. As a result, all patients are considered to be at risk of falls. Staff nurses developed and implemented environmental safety rounds to encompass all patients and situations in order to stratify those at risk. Ongoing assessment and safety checks are documented.
 

Pressure Ulcers

A pressure ulcer is a bedsore. Often, pressure ulcers develop over bony prominences. They can be mild (Stage 0) to severe (Stage IV). According to Patient CareLink, in 2007, there were more than 258,000 cases of reported, preventable pressure ulcers in hospitalized patients.

Some of the measures used to reduce pressure ulcers among hospitalized patients include assessing risk at admission and reassessing risk daily; turning patients at regular intervals to relieve pressure; and following other established protocols.

During the past year, Lahey Hospital & Medical Center has made a significant effort to reduce the incidence of hospital-acquired pressure ulcers and to systematically address the needs of patients who have pressure ulcers upon admission. Initiatives have included a team of “skin care champions” who help educate staff nurses on pressure ulcer prevention and a program of classes and resources available to all nurses.
 

Health Care-Associated Infections

Healthcare-Associated Infections (also called nosocomial infections) include catheter-related (bloodstream) infections, surgical site infections and ventilator-associated (pneumonia) infections.

Research shows that health care organizations can reduce the risk of HAIs by following evidence-based practices, such as consistent hand hygiene, using catheters only when absolutely necessary, and following contact precautions.

At Lahey Hospital & Medical Center, an experienced team of infection control specialists work to minimize infectious threats. In recent years, Lahey has achieved progress in this area:

• Fewer than 1 percent of our surgical patients develop surgical site infection. Read more about the Surgical Care Measures. 
• We have reduced IV catheter-associated infections by 87 percent and reduced ventilator-associated pneumonia by 76 percent following implementation of standardized practices and educational programs.

Hospital Readmissions

Patients with complex medical needs often require multiple specialists and family members to care for them. When patients transition from one health care setting to another or to their homes, there can be crucial gaps in communication between care providers. The unintended result may be a need to readmit the patient if his or her condition deteriorates.

In an effort to reduce hospital readmissions, Lahey Hospital & Medical Center recently became one of 52 hospitals in three states to join the STAAR initiative, a program of the Institute for Healthcare Improvement. STAAR stands for State Action on Avoidable Readmissions. Member hospitals are examining existing processes, forming teams that represent the continuum of care to address issues that contribute to readmission, and looking at all patients are having the potential to be readmitted.