In recent years, the U.S. Veterans Affairs (VA) has been dealing with a rise in serious infections from Clostridium difficile (C. diff), a bacterium that affects the colon, particularly among veteran patients receiving care in hospitals and long-term living facilities.
From 2019 to 2020, C. diff rates spiked significantly at the Columbia VA Community Living Center, therefore increasing both patient safety risks and the length of hospital stays.
However, in 2021, a dedicated process improvement team embarked on a two-step solution to address this growing problem. The first component of this innovative approach encourages more judicious use of antibiotics, while the second integrates best practices right at the point of care, which, crucially, features extensive staff training on two-step testing.
Although C. diff testing commonly employs the polymerase chain reaction (PCR) test—a speedy, efficient diagnostic for infectious diseases—it can sometimes produce false positives. To mitigate this risk, and thereby enhance patient care, the team proposed the addition of a toxin testing stage for all PCR-positive C. diff samples. This second stage of testing facilitates the identification of a toxigenic, or toxin-producing, C. diff infection, making it easier for clinicians to prescribe antibiotics appropriately and sparingly.
The process improvement team noted that this new protocol aligns with current recommended testing methodologies for patient care and argued that it could decrease patients’ duration of hospital stay and reduce their risk of acquiring other hospital-borne infections.
After implementing this novel two-step solution in less than a year, the team observed impressive preliminary results: rates of C. diff fell by 51% in acute care and by 100% in long-term care, prompting an estimated saving of around $375,000 for the facility.
These undeniable results won the team the Diffusion of Excellence’s 2022 VHA Shark Tank Competition, thus securing the chance to replicate their practice at the Central Arkansas VA. Bolstered by the support of the Diffusion initiative, the team managed to win over national VHA program office stakeholders and achieved remarkable progress toward extending their approach to the Central Arkansas VA.
This project successfully demonstrated how significant an impact process improvement projects can have on care quality within a healthcare facility.
Excited by this success, the team is eager to inspire other sites with their new practice and intend to submit additional innovations for future VHA Shark Tank competitions.
Source: https://news.va.gov/123628/two-step-solution-to-improving-colon-health/