How Do HAIs Impact Patient Experience?
Don’t hurt me, heal me, be nice to me.
While healthcare executives grapple daily with balancing tight budgets against optimal patient outcomes, an obvious question may arise “where does accountability fall, stakeholders or shareholders”?
In this context, the shareholders being the executives who must handle the day to operations of a healthcare organization, and the stakeholders being the recipients of care. In most cases, both goals converge. Where this balancing act becomes more complex is instances when they diverge, sometimes widely.
The role infection risks play in achieving patient experience
For Healthcare providers, the best patient outcomes from every contact is that goal we all strive to attain, guided by internal and external regulatory requirements, best practices ongoing research and more. However, limited resources are a clear and present constraint that overarches all our efforts.
A quick review of this complex landscape illustrates just a few of the risks to be navigated and managed:
1. The growth of antibiotic resistance
Former CDC Director Tom Frieden, MD, told The Washington Post in 2016 that, “The end of the road isn’t very far away for antibiotics — that we may be in a situation where we have patients in our intensive care units, or patients getting urinary tract infections for which we do not have antibiotics.”
The growing threat of antibiotic resistance is a challenge to exactly what patients expect from their healthcare providers: to get better and not experience harm. In fact, behaviors that support antimicrobial stewardship may be at odds with patient expectations.
2. The challenges of healthcare team transitions
JAMA published a study that concluded, “Among patients submitted to internal medicine services in 10 Veterans Affairs hospitals, end-of-rotation transition in care was associated with significantly higher in-mortality.” Research like this spark important conversations about ensuring consistency in quality of care.
3. The nature of emerging diseases
In 2015 the World Health Organization began releasing the list of Blueprint priority diseases. The list identifies and prioritizes pathogens that have epidemic potential and therefore pose the greatest public health risk. Combined with headline-making emerging diseases like Zika and Ebola, the conversation about managing these growing public health concerns is changing.
This is only a few items on an increasingly long list that also includes discussions about data and transparency in healthcare, reprocessing and sterilization issues of healthcare equipment and much more. In the daily grapple of healthcare prioritization, balancing these competing concerns is no small task.
Infection prevention and patient outcomes
The IHI Triple Aim focuses on improving the patient experience of care, population health and reducing per capita cost as a unitary goal.
Today improved healthcare data collection and data analytics coupled with evolving regulatory benchmarking requirements lends more insight into what factors impact patient experience and influence their decision of where and how to receive care.
From this holistic approach, conversations have started about what information patients should have about risks like HAIs and even what, if any, role patients can play as partners in infection prevention. As health seeking behavior becomes more informed it may be more common for patients to want answers to questions like:
• What are the infection rates for intended procedure?
• What types and number of HAI cases have been reported for the index facility?
• What policies, audits and actions take place to combat HAI at the facility?
• What are the facility’s infection rates compared to the state and national averages?
The answers to these questions are progressively becoming more available in the public domain, and the impact of these answers cannot be overstated.
The CDC estimates that one in 25 hospital patients has at least one healthcare-associated infection — it’s not difficult to imagine how this might impact a patient’s experience in a healthcare setting. The toll of HAIs is significant; the more than 1.7 million HAIs estimated to occur each year according to the Agency for Health Research and Quality (AHRQ) are associated with 99,000 deaths and costs over $28 billion.
The question then becomes, what strategies can be put into place to not only mitigate the emerging challenges in infection prevention but also to moderate their effect on the patient experience?
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