Major Strides in Pressure Injury Prevention Reported by Joint Commission

Process improvement project with leading hospitals results in over 60% drop in HAPIs

A year-long, collaborative effort by the Joint Commission Center for Transforming Healthcare (JCCTH) and three major hospitals aimed at lowering the rate of hospital-acquired pressure injuries (HAPIs) has delivered show-stopping results. And it could not have come at a better time.

The Johns Hopkins Hospital, Kaiser Permanente South Sacramento Hospital and Memorial Hermann Southeast Hospital achieved a 62% average relative reduction in HAPIs after implementing process improvements under the JCCTH’s guidance. This was equal to preventing 78 pressure injuries and saving $15.3 million, JCCTH stated. The results are even more remarkable because the hospitals sustained this improvement even as the COVID-19 pandemic accelerated.

The joint project was launched in August 2018 to identify ways to prevent and reduce the incidence of pressure injuries. Working with JCCTH, each hospital used Robust Process Improvement (RPI)—a combination of Lean, Six Sigma and formal change management—to identify the root causes of pressure injuries in their daily work and implement countermeasures to address them.

Pressure injury causes and solutions

In an interview with Modern Healthcare, Klaus Nether, executive director of high reliability service delivery at the Joint Commission Center, said the JCCTH project identified these reasons for pressure injuries:

• Lack of education on how they are likely to occur,
• Issues with identifying poor skin integrity,
• Friction from use of medical devices, such as catheters and ventilators, and
• Problems with assessing and documenting injuries.

The Joint Commission plans to expand the pressure injury prevention project to more hospitals and other care settings by the first quarter of 2021, according to the above-referenced Modern Healthcare article. Meanwhile, hospitals can piggyback on the project’s early findings and solutions. Steps may include continuing education for nurses on pressure injury causes and prevention and greater use of digital imaging to assess and document wounds.

Digital imaging offers 95+% accuracy rate

Accurate wound measurement is critical for treatment and healing, and digital imaging has earned its reputation as the gold standard in this area. To this point, Tissue Analytics’ (TA) digital photo technology has a 95+% accuracy rate, whereas measuring wounds with rulers is only 55% accurate and subject to significant variabilities.¹

Additionally, it was also determined that TA’s digital imaging solution saves 5-10 minutes per patient in documentation time, resulting in a minimum of 2.5 hours of charting time saved daily.¹  This enables clinicians to use this extra time to discuss more informed treatment decisions for the patient’s wound outcome management pathway.

As government programs continue to focus on improving quality in wound care treatment and prevention, accurate and efficient documentation is absolutely essential for hospitals.

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HAPIs in regulators’ crosshairs

Indeed, the success of the JCCTH project comes as the federal government is increasing its efforts to reduce HAPI-driven costs. The heightened urgency was highlighted by HHS’ Agency for Healthcare Research and Quality (AHRQ) in its most recent report on trends in hospital-acquired conditions. The AHRQ National Scorecard on Hospital-Acquired Conditions showed that while “harms” decreased in nine out of 11 measured categories, from infections to falls, pressure injuries rose 6%.

AHRQ was looking for a 20% reduction in all hospital-acquired conditions by 2020—a significant jump from 13% between 2014 and 2017. Pressure injuries represent “an opportunity” for significant improvement, the agency states—a clear signal that this will be a major concern and priority. Fortunately, the JCCTH project shines new light on where hospitals should focus.

Net Health and Tissue Analytics provide the process, tools and technologies to digitally document and manage patient outcomes. To find out how we can help your organization champion your wound causes, contact us at 844.464.9348 option 2 or woundcare@nethealth.com.

¹Tissue Analytics Data on File