WWW Iowa Healthcare Collaborative

Building transparency to reduce healthcare-associated infections

Healthcare-associated infections (HAIs) are a major national public health problem, responsible for an estimated two million infections, 90,000 deaths and $4.5 billion in excess healthcare costs each year.1 Despite the best efforts of medical professionals, patients sometimes contract infections while being treated for something else.

The Iowa Healthcare Collaborative developed a multi-year strategy to reduce HAIs in Iowa. Our objectives are to:
  1. Increase awareness about HAIs among providers and the public
  2. Convene a discussion in the Iowa healthcare community to standardize definitions and metrics around infection reporting
  3. Promote public reporting of HAI information in Iowa
Identifying when HAIs occur is the first step toward determining causes and ultimately preventing them-thereby increasing patient safety and the quality of healthcare provided to Iowans. In 2006, IHC worked with infection control professionals around the state to identify a set of consistent, evidence-based measures and develop standard definitions. We then gathered statewide endorsement of six selected measures for data collection:
  • Influenza vaccination among healthcare workers
  • Central line infection rates
  • Surgical site infection rates for four types of surgeries: colon, hip, hysterectomy and coronary artery bypass graft
Armed with the buy-in of providers statewide, IHC set a date of January 1, 2007, for providers to begin standardized voluntary reporting on the HAI measures-a specific commitment to transparency that no other healthcare organizations in the country have made. More than 100 Iowa hospitals are currently reporting on one or more of these measures.

"We're collecting data to establish a baseline," explains Kathy Trytten, director of information and quality management with the Iowa Hospital Association. "This information will help prove that following evidence-based procedures really does reduce the likelihood of infection."

"FluBusting" at Waverly Health Center

By the nature of their work, healthcare workers are at great risk of acquiring and transmitting influenza to patients, their families and the community in general. Influenza vaccination decreases the disease burden on these individuals, reduces absenteeism and helps maintain the healthcare workforce during influenza epidemics.

Nationally, only about 40 percent of all healthcare workers are immunized against influenza each year. Iowa's current rate is nearly 68 percent, and IHC is participating in a multi-year statewide campaign to increase influenza vaccination of Iowa healthcare workers to 95 percent by 2010.

Waverly Health Center is among a handful of Iowa hospitals leading the way. Waverly Health Center achieved an impressive 94.8 percent staff influenza vaccination rate following a 2006 "FluBuster" campaign. The hospital's FluBuster committee members teamed up with employee health to encourage influenza vaccinations in innovative and fun ways:
  • A "Vaccine Mobile" traveled to all departments throughout the week offering both the injectable flu vaccine and the FluMist® vaccine.
  • Detailed influenza vaccine information sheets were posted and "Myth Buster" cards were made available in every department to help dismiss any concerns regarding the vaccination.
  • Staff members were photographed and included on posters displayed throughout the health center encouraging others to be a FluBuster.
  • Paycheck stuffers were inserted into all paychecks with stickers featuring the "Be a FluBuster" campaign logo.
  • After staff members received their vaccination, they received a sticker that said, "I'm a FluBuster!"
  • The hospital treated all staff members to a caramel apple sundae party.
In March, the National Influenza Vaccine Summit announced recipients of its first annual Immunization Excellence Awards, and Waverly Health Center was honored as runner-up in the Healthcare Worker Campaign category. "This recognition is a tremendous honor and I know Waverly Health Center can achieve a voluntary 98 percent vaccination rate with more education," says Dixie Kramer, infection control and occupational health manager. "The high rate of immunization increases herd immunity among our staff, and this in turn lowers patients' risk for influenza."

1 Institute for Healthcare Improvement, Rapid Response Teams report, www.ihi.org/ihi/programs/campaign

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