Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

AHRQ Director Carolyn Clancy, M.D., has prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They will address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan. Check back regularly for new columns.

If you're a football fan like I am, you know that teams win or lose depending on teamwork. A good team may have a quarterback who can throw an accurate pass. But a great team also has players who can protect the quarterback and catch those passes.

In short, when teams work together, everyone can do their best job.

Today, this approach is catching on in health care in a big way. Doctors, nurses, and other staff have always depended on each other to provide high-quality care to patients. Now they're learning how to apply specific teamwork principles to produce better and safer care.

A terrific example is how clinicians are reducing—and even getting rid of—infections that patients can get while they are in the hospital. Healthcare-associated infections happen when patients are in the hospital getting treatment for another condition. They affect 1 in 20 patients at any point in time.

People used to think that these infections couldn't be avoided.

Now, we know this is not the case. In fact, a newly completed program showed that a combination of teamwork, the best clinical practices, and a strong commitment to safety reduced by 40 percent the chance that patients would get one type of these infections. The national project was funded by my agency, the Agency for Healthcare Research and Quality, and involved partners from the American Hospital Association and Johns Hopkins Medicine.

The type of infection tested in this project happens in intensive care units when germs infect the central line that delivers drugs and fluids patients. The infection is very serious and can be deadly. By following this teamwork-based approach, hospitals prevented more than 2,000 infections, saved 500 lives, and avoided more than $34 million in health care costs.

Results of this project, called the Comprehensive Unit-Based Safety Program, or CUSP, are exciting for two reasons. One is that it proves how a careful, teamwork-based approach can prevent a deadly type of infection. The second reason is that the program can also make care safer for patients with other health conditions.

Let's take the case of Laura, a hypothetical 70-year-old patient who is in the hospital after having a stroke. She is on a ventilator to help her breathe until she recovers. But being on a ventilator also puts her at higher risk for getting pneumonia.

Laura is fortunate that her hospital team is using CUSP as a part of her care. As a result, Laura's doctors, nurses, respiratory therapists, and others make sure the head of her bed is raised to the right level, check that hands are always washed properly before all exams, and follow all other infection-control steps. Laura's care team members talk to each other every day to make sure that everyone follows the care plan.

In addition to the clinical staff, Laura's family members are considered part of the team. The care team explains to the family why pneumonia is a risk, what steps they are taking to prevent it, and how to help.

You may not know whether your hospital is using CUSP. But you should speak up if you're concerned or unsure about the care your loved one is getting. If you need help asking questions, check out this resource for help.

Of course, teamwork and other important elements of CUSP can't change the outcome of every illness or condition. But they help many patients avoid getting sicker and help clinicians work together to do what they do best.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

Resources

Agency for Healthcare Research and Quality
AHRQ Patient Safety Project Reduces Bloodstream Infections by 40 Percent
http://www.ahrq.gov/news/press/pr2012/pspclabsipr.htm

Using a Comprehensive Unit-Based Safety Program to Prevent Healthcare-Associated Infections
http://www.ahrq.gov/qual/cusp.htm

Questions are the Answer: Questions for Your Health Care Provider
http://www.ahrq.gov/questions/tenquestions.htm

American Hospital Association
AHRQ patient safety project reduces bloodstream infections by 40 percent
http://www.aha.org/search?q=CUSP&site=redesign_aha_org

Johns Hopkins Medicine
http://www.hopkinsmedicine.org

Current as of October 2012
Internet Citation: Teamwork a Key Feature of Patient Safety Improvement Program. October 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/20121002.html