MEDIA RELEASE

For Immediate Release:
April 30, 2009

LHSC and St. Joseph’s report safety rates

(LONDON, Ontario) - As part of the province-wide public reporting initiative from the Ministry of Health and Long-Term Care, London Health Sciences Centre (LHSC) and St. Joseph’s Health Care, London (St. Joseph’s) posted their indicator rates today.

LHSC and St. Joseph’s posted surgical site infection (SSI) prevention and hand hygiene compliance rates. In addition, LHSC posted rates for central line infections (CLI) and ventilator associated pneumonia (VAP) – these indicators do not apply to St. Joseph’s.

Hand Hygiene Compliance
The hand hygiene compliance rate is based on the number of times care providers comply with the

4 moments of hand hygiene:

1. Before initial patient/patient environment contact
2. Before aseptic procedure
3. After body fluid exposure risk
4. After patient/patient environment contact
Moments 1 and 4, the most important opportunities to prevent infections, are publicly reported.

The rates for both LHSC and St. Joseph’s are low. “Our rates of hand hygiene compliance are unacceptable,” said Cliff Nordal, president and CEO of St. Joseph’s and LHSC. “Since we completed the hand hygiene audit in August 2008, we’ve done a tremendous amount of education and placed hand cleaner by bedsides to improve our hand hygiene rates. We know our compliance rates are improving; nevertheless, we still have a lot of work to do.”

LHSC and St. Josephs will again be auditing hand hygiene this summer, and will publicize the results at that time. “I am confident this second audit will show increased compliance, from what we are reporting today,” said Nordal.

Everyone from physicians and care providers to patients and families is responsible for cleaning their hands in the right way at the right time.

”It’s up to everyone who works at, or comes to, a hospital to be vigilant about hand hygiene. We all need to be part of the solution,’ said Nordal.

“We want to be clear that health care providers are washing their hands, and continually improving the practice as more is learned about hand hygiene best practice,” said
Dr. Gillian Kernaghan, integrated vice-president of medical education and medical affairs. “Our goal is to make cleaning hands at the 4 moments for hand hygiene—which is an extremely high standard—second nature.

Surgical Site Infection (SSI) Prevention
The SSI prevention percentage refers to the use of antibiotics that help prevent surgical site infections from occurring in hip and knee joint replacement surgeries. Specifically, it is the percentage of these surgical patients who received a prophylactic, or preventative, antibiotic within the appropriate time prior to surgery. Appropriate times are within 60 minutes for standard antibiotics, and 120 minutes for Vancomycin. Actual surgical site infections are not reported.

“It is important to understand that this indicator is measuring a window for administering the antibiotics, which is best practice. If the antibiotic is not administered at the ideal time, this would be shown as not-compliant in the results,” says Kirsten Krull-Naraj, integrated vice president, surgery services. “This does not mean that patients didn't receive the antibiotics. Staff are administering the antibiotics, and we continue to improve our processes to ensure that our patients receive the antibiotics within the most appropriate time frame.”

Ventilator associated pneumonia (VAP) and central line infections (CLI)
When a patient requires long-term access to medication through an IV, a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream, causing a patient to become sick. Patients in the ICU often require a central line since they are seriously ill, and will require a lot of medication, for a long period of time.

Ventilator associated pneumonia is a pneumonia (lung infection) occurring in patients in an intensive care unit (ICU), requiring external breathing support, intermittently or continuously, through a breathing tube for more than 48 hours. VAP can develop in patients because they are relying on an external machine to breath amd their normal coughing, yawning, and deep breath reflexes are suppressed.

“We are pleased with these results and will continue to maintain this high quality of care for our patients,” said Krull –Naraj.

Success in these areas is due in part to the implementation of the “safer health care now” educational initiative for CLI and VAP

Backgrounder attached with public reporting statistics for LHSC and St. Joseph’s

For the complete patient safety indicator report from the Ministry of Health and Long Term Care, please visit www.ontario.ca/patientsafety

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For more information contact:

Cory Habermehl Laura Dockstader
Corporate Communications Communication and Public Affairs
& Public Relations St. Joseph’s Health Care, London
London Health Sciences Centre (519) 646-6100 ext. 47368
519-685-8500, ext. 58738  


For after hours assistance:
LHSC: call 519-685-8500 and ask to have the communicator on call paged
St. Joseph’s: call 519-646-6100 and ask to have the communicator on call paged

 

Backgrounder
St. Joseph’s Health Care London
April 30, 2009 public reporting

The hand hygiene audit at St. Joseph’s was conducted in the summer of 2008.

 

Moment 1 compliance

Before initial patient/patient

environment contact

Moment 4 compliance

After patient/patient environment contact

Parkwood Hospital

26.91 %

42.69 %
Regional Mental Health Care London
33.03 %
56.46 %
Regional Mental Health Care St. Thomas
48.55 %
66.07 %
St. Joseph’s Hospital
43.68 %
61.54 %

St. Joseph’s is stepping up efforts to improve hand hygiene compliance. For example, at Parkwood Hospital care providers from each unit are being trained as hand hygiene champions, so they can leverage their knowledge and enthusiasm for correct hand hygiene practices with their team members.

Surgical Site Infection (SSI) Prevention
St. Joseph’s Hospital’s SSI prevention rate is 56.52%.

Staff are administering the antibiotics, and we continue to improve our processes to ensure that our patients receive the antibiotics within the ideal time frame. We are also working on better data collection processes, to ensure that our SSI percentages are as high as possible.

For complete information on hand hygiene compliance and surgical site infection prevention rates at St. Joseph’s, please visit www.sjhc.london.on.ca and click on “How we perform.”

 

About St. Joseph’s Health Care London
St. Joseph’s Health Care, London is a major patient care, teaching and research centre with a distinguished legacy of service to London, Southwestern Ontario and the veterans of Canada, dating back more than 130 years. St. Joseph’s five key role areas include acute/ambulatory care, complex care and veterans care, long-term care, rehabilitation and specialized geriatrics and specialized mental health care. Facilities and services including St. Joseph’s Hospital, Parkwood Hospital, Mount Hope Centre for Long Term Care and Regional Mental Health Care London and St. Thomas are part of the St. Joseph’s family. Our research arm, the Lawson Health Research Institute, continues to direct their research to the development of new knowledge that is continually being applied directly to patient care. More than 400,000 patients annually receive care from close to 6,000 physicians and staff at St. Joseph’s. St. Joseph’s is affiliated with the University of Western Ontario.

 

Backgrounder
London Health Sciences Centre
April 30, 2009 public reporting

The hand hygiene audit at LHSC was conducted in the summer of 2008.

HAND HYGIENE COMPLIANCE

Moment 1 compliance

Before initial

patient/patient

environment contact

Moment 4 compliance

After patient/patient

environment contact

University Hospital
27 %
63 %
Victoria Hospital
13 %
39 %
South Street Hospital
Not applicable
Not applicable


The data for both University Hospital and Victoria Hospital shows there is significant room for improvement. To help improve hand hygiene compliance, on-going efforts are being made at both hospitals to increase the number of alcohol-based hand rub stations available to staff. In addition, educational initiatives are being further implemented at both hospitals.

 

SSI
Rate
University Hospital
82 %
Victoria Hospital
25%
South Street Hospital
Not applicable

The Victoria Hospital rate represents a very small number of cases, each of which involved trauma patients and trauma surgeries. In these types of cases, there are often many competing factors. The process around timing of administration of antibiotics in these types of cases continues to be examined and standardized at Victoria Hospital.

CLI & VAP
 
Rate
CLI University Hospital
1.37
  Victoria Hospital
0.74
  South Street Hospital
Not applicable
VAP University Hospital
3.02
  Victoria Hospital
3.63
  South Street Hospital
Not applicable

LHSC is pleased with these results and will continue to maintain this high quality care for our patients. Success in these areas is due in part to the implementation of the “safer healthcare now” educational initiative for CLI and VAP.

About London Health Sciences Centre
London Health Sciences Centre has been in the forefront of medicine in Canada for over 130 years and offers the broadest range of specialized clinical services in Ontario. Building on the traditions of its founding hospitals to provide compassionate care in an academic teaching setting, London Health Sciences Centre is home to South Street Hospital, University Hospital, Victoria Hospital and Children’s Hospital, two family medical centres, and Lawson Health Research Institute - a joint research initiative with St Joseph’s Health Care, London. As a leader in medical discovery and health research, London Health Sciences Centre has a history of over 30 international and national firsts and attracts top clinicians and researchers from around the world. As a regional referral centre, London Health Sciences Centre cares for the most medically complex patients including critically injured adults and children in Southwestern Ontario and beyond. The hospital’s 10,000 staff, physicians, students and volunteers provide care for more than one million patient visits a year. For more information visit www.lhsc.on.ca

 

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Last Updated April 30, 2009 | © 2007, LHSC, London Ontario Canada