Guidelines for all central lines to be placed by ultrasound passed by system physician committees and by all medical executive committees Ultrasound machines purchased to support increased need Multiple sessions for training for physicians held at all sites March 2011 all sites received adequate training and equipment – Compliance data widely distributed monthly Non compliance data individually distributed to operators and leadership Complication of pneumothorax without ultrasound presented at leadership meetings and medical executive committees. Awards for 12 months of no pneumothoraces to hospitals Results (max points 250): Compliance with ultrasound use for central line placement has increased to over 80% at all 10 hospitals within 12 months (March 2011 March 2012) of – training completion. All hospital have sustained high level of utilization 8 of 10 hospitals have attained greater than 90% utilization compliance by June 2012 4 of 10 hospitals have reached 0 pneumothorax rates for 12 months. Revenue Enhancement /Cost Avoidance / Generalizability (max points 200): We did not calculate the financial effects of this intervention. Decreased rates of line associated pneumothorax have been noted throughout the 10 hospital system (4 of 10 hospitals have reached 0 pneumothorax rates for 12 months). Future CMS funding reduction for complications and patient satisfaction should be considered. Conclusions and Next Steps: We adopted ultrasound utilization for all line placements to improve patient safety in a 10 hospitals (academic, community, rural, specialty). Decreased line related complications have been observed throughout the system. This project directly contributes to our and institution’s overall goal of reducing patient harm and potentially decreasing hospital length of stay, and reducing costs of care. Our goal is to sustain this practice in our institution and healthcare system and share knowledge gained by this large implementation with other healthcare organizations.
Guidelines for all central lines to be placed by ultrasound passed by system physician committees and by all medical executive committees Ultrasound machines purchased to support increased need Multiple sessions for training for physicians held at all sites March 2011 – all sites received adequate training and equipment Compliance data widely distributed monthly Non compliance data individually distributed to operators and leadership Complication of pneumothorax without ultrasound presented at leadership meetings and medical executive committees. Awards for 12 months of no pneumothoraces to hospitals Results (max points 250): Compliance with ultrasound use for central line placement has increased to over 80% at all 10 hospitals within 12 months (March 2011 – March 2012) of training completion. All hospital have sustained high level of utilization 8 of 10 hospitals have attained greater than 90% utilization compliance by June 2012 4 of 10 hospitals have reached 0 pneumothorax rates for 12 months. Revenue Enhancement /Cost Avoidance / Generalizability (max points 200): We did not calculate the financial effects of this intervention. Decreased rates of line associated pneumothorax have been noted throughout the 10 hospital system (4 of 10 hospitals have reached 0 pneumothorax rates for 12 months). Future CMS funding reduction for complications and patient satisfaction should be considered. Conclusions and Next Steps: We adopted ultrasound utilization for all line placements to improve patient safety in a 10 hospitals (academic, community, rural, specialty). Decreased line related complications have been observed throughout the system. This project directly contributes to our and institution’s overall goal of reducing patient harm and potentially decreasing hospital length of stay, and reducing costs of care. Our goal is to sustain this practice in our institution and healthcare system and share knowledge gained by this large implementation with other healthcare organizations.
Utilization-of-Ultrasound-for-Central-Venous-Line-Insertion.docx