Introduction Healthcare mistakes can be costly (Kelly & Klim, 2013). One particular mistake that is a common source of costliness and wasteful spending on many levels is the improper collection of blood cultures. Blood culture collection is a necessity in the treatment of many conditions, including pneumonia, cellulitis, and other bacterial infections (). INSERT STUFF FROM PHONE HERE .Blood cultures provide a guide for diagnosing and treating a patient with sepsis (Kelly & Klim). Self et al. (2013) agrees that the unnecessary interventions from contaminated specimens prove to cost the hospital time, effort and thousands of dollars Guidelines for the proper collection of blood cultures include many recommendations that exhibit quality and excellence. This paper’s purpose is to identify an evidence-based project (EBP) proposal for proper blood culture collection, especially in the emergency department setting by identifying the problems associated with blood culture draws, addressing the need for change in practice. Assessing the need for change in practice consists of identifying stakeholders, in the change process, collecting and analyzing data collected, identifying the problem and presenting outcomes and interventions for the problem (Larrabee, 2012).
Quality Measures: Clinical excellence and quality Quality is the standard by which a benchmark is set. This may be for a service or a good. Quality is the benchmark by which we think something is not only done right
A total of 5,432 blood cultures were obtained from 2,642 patients and a significantly lower rate of contamination were seen in those specimens obtained by a dedicated phlebotomist. The phlebotomist collected cultures had a contamination rate of 2.4-3.6%, with an overall rate of 3.1% and the non-phlebotomy collected cultures showed contamination rates 6.2-10.2%, with an overall rate of 7.4% (Gander et al., 2009). The difference in the median patient charges between the negative ($18,752) and false-positive cultures ($27,472) resulted in additional charges totaling $8,720 for each contaminated event (Gander et al., 2009). The median increase for length of stay only increased from 4 days (negative culture) to 5 days (false-positive culture); whereas, patient’s with significant bacteremia had an additional median charge of $32,303 and 8-day median length of stay (Gander et al., 2009). This study goes on to state that with the estimated $8,720 for each episode of a contaminated blood culture, the prevention of only five contaminated blood cultures a year might fund the yearly salary for one dedicated phlebotomist in the ED and could potentially save the hospital $4.1 million in excess charges annually (Gander et al., 2009). This literature precisely defines reasonable need for correct collection of blood cultures in the emergency setting and provides evidence for former PICOT question.
This course provided me with invaluable insight into the way change works within a large hospital setting. While I love research, in my experience and true for this course, with any hands-on project you learn so much more than just investigating facts or submitting assignments. Honestly, at first I was intimidated about approaching the “higher-ups” in my organization; however, over-time approaching leaders and staff peers about the importance of my project became easier. My interest in the topic of blood culture (BC) contamination grew through the vast research completed for the assignments. Passion for the topic followed suite, as my knowledge increased for the subject at hand. I found the leaders of my healthcare organization to be extremely
As I said on the thread discussion,The cost of quality is not the price of creating a quality product or service but the cost of not creating a quality product or service:If an organization can quantify the quality of their products and services, they can use Quality is conformance to requirements as a definition for quality. If an organization cannot quantify, they can use Quality is satisfying the needs and
Service quality - refers to difference between the level of service that is expected from consumers and the perception of the service that is actually received. (Caruana,
Quality may also have many different meanings. Quality in health care economics means the superiority of something. This can also mean the best of something. Quality in health care can be determined by determining if the health care is a great fit for the person. Quality of health care can be considered as the right treatment for the right illness, and also delivering health care at the right time. Quality in health care economics means to give the best health care possible. Getzen (2007), states that medicine often involves life and death situations (p.12). In these situations, quality is crucial and quantity is irrelevant (Getzen, 2007). Quality cannot simply be added up or multiplied to arrive at a total spending limit. In medical care, getting more ounces or pounds or boxes or whatever is usually not very important, but getting higher quality is.
Hospital- acquired infections is also another concern for patients. The common health-acquired infections include surgical site infections, ventilator – associated pneumonia, catheter-associated urinary tract infections, blood stream and bacterial infections. Annually, these types of infections cost the U.S. about $9.8 billion. Topping the list for the most costly burden are surgical-site infections.
Blood culture (BC) contamination is a common, yet preventable problem for emergency departments (EDs) across the country (Self et al., 2014). Erlanger Hospital’s ED is no different and being the region’s only Level 1 Trauma Center, it is called to an excellent standard of practice. BC testing is a routinely applied intervention used to diagnose infections in symptomatic patients who arrive at the ED (Denno & Gannon, 2013). BCs are essential as they help identify accurate pathogens and provide targeted antibiotic therapy (Denno & Gannon, 2013). They are often viewed as the standard for diagnosing illnesses such as septicemia and other
With total U S hospitals costs of over $20 billion, sepsis is one of the most expensive health conditions treated in hospitals (1). According to the Centers for Disease Control and Prevention (CDC), sepsis affects more than 1.5 million people each year, proving fatal for approximately 250,000 of those individuals (2). The CDC estimates that one out of every three patient deaths in a hospital involves sepsis (2). While the incidence of sepsis is reportedly increasing (3, 4), it is difficult to obtain an accurate figure.
As individuals we all have our own perspective on what would amount to quality. With regards to the general public we are a nation of extreme diversity, with individuals and families from a wide-range of nations, cultures, personal beliefs and superstitions. Therefore, quality may and will have contrasting opinions, or values, an example could be as follows: Each of us having a fine meal at a restaurant may or would have contrasting opinion on the setting, service, and the overall quality of the food.
Amidst the futile clamor and commotion of national healthcare reform legislation debated on the national political stage, everyone in the medical industry from patients to doctors alike are searching for ways to effectively and efficiently trim the cost of delivering quality healthcare. While the inexcusable waste and graft of the insurance industry, runaway medical malpractice litigation and the importance of lifelong preventative care are all issues that have been thrust to the forefront of the political discourse, a tremendous leak in the system has escaped notice and continues to drain resources from both hospitals and those they treat. The threat of additional infections afflicting a patient who requires treatment for an original condition is prevalent throughout American hospitals, and according to the U.S. Department of Health and Human Services "Healthcare-associated infections (HAIs)" or "infections that patients acquire while receiving treatment for medical or surgical conditions "¦ occur in all settings of care, including hospital acute care units and same day surgical centers, ambulatory outpatient care clinics, and long-term care facilities, such as nursing homes and rehabilitation centers" (HHS Action Plan, 2011). Whether one attempts to gauge the overall price of healthcare-associated infections in terms of the financial expenditure, the human suffering or the diversion of valuable resources they impose on the healthcare system, it is quite clear that these
On November 7, 2014 Mr. Purgert was informed to return to the emergency room for an evaluation for abnormal blood culture results. Dr. Janathan A. Goroza was the doctor on call that day. He reported that Mr. Purgert was in the ER a few days earlier, and at this time he was complaining of tightness in his chest when he coughs. In addition he also reported having a 101 fever the day before this visit, however, now it is down to 99. Dr. Goroza ran tests on Mr. Purgerts blood and released him from the hospital.
Merriam Webster defines quality as a degree of excellence, or a distinguishing attribute. Managers strive for excellence in the workplace to improve customer satisfaction, increase the output in manufacturing while minimizing defects, as well as making the company more profitable. There are several different management systems or methodologies available for businesses to use, but the Balanced Scorecard and the Malcolm Baldrige Performance Excellence Program is the most common and widely used in the United States.
Quality is defined as conformance to the requirement, not goodness: The first absolute explains that management must strive to ensure that during the quality improvement process everyone is getting things done right the first time. Crosby stated that in other to do this management must state clearly what are the individual roles of the employee, management must also supply the employees with the resources needed to do their task and lastly management must give continuous support and encouragement to the employees during the improvement process. When quality is defined as conformance to requirement it helps to reduce hassle and improve quality at the same time. Crosby (1995).
Deming, Juran, and Crosby all define quality in different ways. Deming defines quality as a continuous improvement and the ultimate goal is zero defects; however, he realizes an error free product may not be economically feasible or practical (Kerzner, 2009, p. 880). Deming also states a product or service is defined by the customer and quality is a relative term and will change based on the customer’s needs (Suarez, 1992, p.3)