How Southern Ohio Medical Center Lowered Hospital-Acquired C. Difficile Rates by 30%

All healthcare organizations want to provide the best care possible for their patients, which makes engaging in quality improvement projects so essential. Our goal when working with our customers is to ensure all care teams have the tools they need for clinical decision-making and analysis so they can turn discrete data into meaningful and actionable insights. By leveraging solutions like surveillance, analytics, and clinical decision support, healthcare providers can streamline processes, minimize errors, and enhance patient outcomes. But with so many quality improvement opportunities available, where does one even begin?

Our advice has always been to start with the areas of greatest need. Transparency is vital: Use analytics to identify where you are falling short and leverage your organization’s Community Health Needs Assessment to determine the greatest needs in your community. One of our customers who has been extremely successful in these efforts is Southern Ohio Medical Center in Portsmouth, Ohio. Its remarkable success serves as a prime example of what can be achieved with dedication and strategic implementation.

Clostridioides difficile infection (CDI) affects approximately 400,000 Americans every year and is responsible for 12,800 deaths, posing a serious threat to public health. SOMC's infection prevention and quality improvement team recognized the need for a multidisciplinary approach to differentiate between active CDI and colonization, leading to the implementation of a screening process.

SOMC identified MEDITECH's Expanse EHR as a potential solution to enhance CDI identification and treatment. Leveraging discrete information, SOMC aimed to automate processes and expedite C. diff testing for timelier decisions. With vendor guidance, they developed a plan based on guidelines from the CDC and leading professional societies and identified potential process improvements.

Results include:

• A 30% reduction in canceled tests. Providers are more acutely aware of when it is appropriate to order a C. diff test.
• 3-5 minutes of lab time saved for each canceled test avoided.
• A 30% decrease in hospital-acquired CDIs.
• 3.5 hours of time saved per week for the ID pharmacist, who no longer needs to manually review orders.

In addition, the CDI quality improvement initiative enabled SOMC to decrease its standardized infection ratio even further, from 0.394 to 0.272, well below the 2000 industry average of 0.52. 

Download their case study to learn more about their efforts.

Building on the success of its C. diff efforts, SOMC turned its attention to another opportunity to reduce antibiotic use and save resources by targeting the treatment of asymptomatic bacteriuria to align with The Joint Commission's 2023 Antibiotic Stewardship update. The goal was to ensure that clinicians only ordered urine cultures when patients met specific clinical criteria, minimizing unnecessary lab orders and subsequently, the administration of antibiotics to asymptomatic patients.

Six months post-implementation, SOMC observed a notable 29% reduction in urine culture orders within acute care settings, indicating the success of their initiative. This achievement underscores SOMC's commitment to enhancing patient care through innovative solutions and effective collaboration with technology partners.

Key Takeaways

• Target those quality improvement projects that would have the greatest impact on the community. Establishing success out of the gate can help set the momentum for the next project.
• When establishing a quality improvement plan, engage stakeholders from across the organization and make it clear why the project is worth their efforts and how it improves patient care.
• Whether for CDI or other quality improvement efforts, clinical decision support helps providers detect CDIs or other infections earlier, while also giving them autonomy over their course of action.
• It is essential to have the right tools and logic in place to support the three key steps to quality improvement: accurately identifying at-risk patients, ensuring timely notifications, and measuring success through advanced analytics.