New Ulm Medical Center leads the state, nation in best practices tracked in certain diagnoses

New Ulm Medical Center (NUMC), along with many other hospitals across the state and country, track certain diagnoses to determine if best practices are followed for patients with those diagnoses. NUMC leads the state and the nation with their best practices scores for those particular diagnoses.

Currently, NUMC tracks three diagnoses: congestive heart failure (CHF), pneumonia and acute myocardial infarction (AMI) – also known as a heart attack. In 2010, NUMC will begin tracking the treatment of stroke patients. They're also tracking surgical care for surgeries. Outcomes for all of these are reported to the healthcare accreditation organization The Joint Commission; Centers for Medicare and Medicaid Services (CMS); and soon the state of Minnesota.

For all three diagnoses that are tracked, NUMC had perfect scores in the third quarter of 2009. "That means that every patient who was seen for each of these diagnoses was treated with best practices 100 percent of the time,” said Kathy Thompson, NUMC quality/risk manager.

In each of the three areas, there are various actions that are measured to determine if best practices are being followed.

Congestive heart failure

More than 5.3 million Americans have heart failure. This type of heart disease is the most frequent reason why people older than 65 are admitted to the hospital. Heart failure does not mean your heart is about to stop working. It also doesn't mean that you've had a heart attack. Heart failure means your heart isn't pumping blood as well as it should.

When a person is diagnosed with CHF, best practices prescribes that their:

• heart function is monitored and if it's not improving, they're put on medication.
• given smoking cessation education (where applicable).
• provided with education and instructions when discharged from the hospital so they know how to maintain their health. These instructions include: weighing themselves daily; following a low-sodium diet to prevent excess fluid; education on how to take medications correctly; having follow-up visits with their health care provider; maintaining physical activity; and knowing how to identify if their symptoms are worsening.

In addition to these best practices, Thompson said, another indicator of excellent care of NUMC's CHF patients is that only 10 percent of patients with this diagnosis were readmitted to the hospital in 2009.

Pneumonia

Pneumonia and influenza together ranked as the eighth leading cause of death in the United States. Between the two, pneumonia consistently accounts for most deaths. Pneumonia is an infection of the lungs caused by bacteria, a virus or fungus. The illness occurs most often in the winter. It's especially deadly to the elderly, the very young and people with health problems, such as asthma, diabetes, heart failure and diseases that affect the immune system.

When a patient is admitted to the hospital with a pneumonia diagnosis, a first dose of antibiotic medicine within six hours of arrival is important if bacteria caused the infection.

Other pneumonia best practices that are measured at NUMC are:

• providing smoking cessation education, when applicable.
• administering the pneumococcal vaccine to appropriate patients.
• administering the flu shot to pneumonia patients during flu season, because the flu can lead to a recurrence of pneumonia.

Again, in all these areas, NUMC scored 100 percent in third quarter 2009. Readmission rates for pneumonia patients at NUMC were also extremely low at 4.4 percent.

Acute Myocardial Infarction (heart attack)

Heart disease is the number one killer in the United States. Unfortunately, heart attacks often alert people to the fact that they have heart disease. A heart attack – also called acute myocardial infarction (AMI) – means that part of the heart muscle may be damaged. The damage occurs when a blood clot blocks blood flow to the heart, depriving it of oxygen.

When a patient comes through the doors of NUMC with a heart attack:

• They are given an aspirin and beta blocker medicine. Aspirin helps thin the blood, preventing blood clots from forming. Beta blockers improve the hearts ability to relax – it slows the heart rate.
• They may be given thombolytic therapy if doctors suspect a blood clot is causing the heart attack.

Before being discharged, AMI patients who smoke are given smoking cessation education.

Surgical Care Improvement Project

All surgeries have their risks. Blood clots and infections are common problems that can lengthen hospital stays and shorten lives. The Surgical Care Improvement Project (SCIP) tracks a number of steps to ensure they are always in place for NUMC surgical patients.

• The patient is given a preventive antibiotic to prevent infection one hour prior to surgery.
• That same antibiotic is stopped before 24 hours after the end time of surgery.
• Blood clot prevention steps are put in place, such as the use of the blood thinning medicines Coumadin or Heparin; or leg compression devices. The type of blood clot prevention measures used is based on the type of surgery.
• The patient's temperature is measured during major abdominal surgeries to make sure it doesn't drop too low. A dropping temperature increases the risk of infection.

This year, NUMC will also begin tracking best practices in stroke patients who are admitted to the hospital. All of these best practice tracking initiatives are part of a larger initiative of the Minnesota Department of Health, Thompson said, "The theory being that, if you have to report your scores, you'll pay closer attention to your processes and treatments.”

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New Ulm Medical Center
1324 Fifth North Street
New Ulm, MN 56073
507-233-1000
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