An oral care project implemented by SoutheastHEALTH in eastern Missouri resulted in nearly $1 million in cost avoidance per quarter. Specifically, the actions by a multidisciplinary team at the facility in Cape Girardeau led to a 71% reduction in non-ventilator health care-associated pneumonia, a 51% reduction in pneumonia readmissions and a 69% reduction in sepsis mortalities. Collectively, these improvements resulted in an average cost avoidance of $850,000 per quarter.
SoutheastHEALTH recognized the need to improve hospital-acquired pneumonia after experiencing their worst statistics with 45 cases in one quarter. The first action implemented was oral care to all pre-op patients prior to a procedure. This played a direct part in reducing post-op pneumonias and sepsis in elective surgeries, said Regina Moore, RRT, CLSSGB, Quality Management-Clinical Quality Analyst at SoutheastHEALTH.
Additionally, the oral care project was expanded to include all intensive care unit patients, which further reduced cases of hospital-acquired pneumonia. Soon, implementation of the initiative included more teams, incorporating nurses, pharmacists, materials management, physical, occupational and speech therapists, information technology personnel and respiratory therapists into the process. The quality improvement team facilitated the effort and gathered data through audits.
Department roles included:
Nursing: Served as key drivers of oral care practices and sources for feedback regarding the most effective workflows.
Pharmacy: Assisted with recognition of gaps in patient care and added oral care kits to medical record information in their daily unit rounds. They also educated nursing staff in real time.
Materials Management: Ensured supplies were adequate for each nursing unit.
Physical Therapy/Occupational Therapy/Speech Therapy: Assessed patient populations to recognize anyone in need of extra help with oral hygiene. The stroke population was a heavy focus for them.
Information Technology: Added oral care to order sets, tasks lists and medical records.
Respiratory Therapy: Ensured that ventilator and BiPAP patients received proper oral care and assisted nurses as needed.
When word of the project’s success reached SoutheastHEALTH’s leadership, the project was further expanded to send all discharged patients home with a toothbrush and toothpaste packets, along with an education hand-out detailing the importance of oral care. Additionally, the hospital’s Foundation Department was able to secure a grant to provide patients being discharged with oral care supplies for home use.
SoutheastHEALTH is a 2022 Health Quality Innovator of the Year runner up in the Collaboration Category. Click HERE to read about all of the winners and runners up.