How to decrease HAI costs by 30% with two easy steps Stephanie - - PowerPoint PPT Presentation

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Dec 03, 2022 218 likes •333 views

How to decrease HAI costs by 30% with two easy steps Stephanie Taylor, MD, M Arch M. Colin Tasi, MD, MBA Candidate Traci Hanegan, PE, HFDP, LEED AP BD+C Executive Summary Impact of reduced operating margins Current healthcare

SLIDE 1

Stephanie Taylor, MD, M Arch

M. Colin Tasi, MD, MBA Candidate

Traci Hanegan, PE, HFDP, LEED AP BD+C

How to decrease HAI costs by 30% with two easy steps

SLIDE 2

Executive Summary

Impact of indoor environment

Pathogen transmission
Pathogen infectivity
Patient defenses

Barriers to indoor air management

Misconceptions about mold and allergies
Operations and Maintenance
Effect on costs associated with building energy use

Necessary actions

Key steps for hospital leadership
Important considerations during implementation
Potential benefits in financial performance

Current healthcare

perational landscape
Impact of reduced operating margins
Emphasis on P4P reimbursement system
Current quality efforts and gaps

SLIDE 3

Despite excess costs, HAIs are alarmingly common and create significant financial burden

40,381 133,806 158,768 33,482 76,973 CLABSI C Diff SSI UTI VAP

Annual incidence of 5 most common HAI's in the US*

$45,814 $11,285 $20,785 $896 $40,144 CLABSI C Diff SSI UTI VAP

Direct hospital cost per HAI case CLABSI

$1.85B

VAP

$3.03B

SSI

$3.30B

C. Diff

$1.51B

UTI

$0.03B 31.6% 18.9% 15.4% 33.7% 0.03%

Total annual HAI cost: $9.8B

*2013 annual volume

Zimlichman E, Henderson D, Tamir O, et al. HAIs: A Meta-analysis of Costs and Financial Impact on the US Health Care System. JAMA Intern Med. 2013;173(22):2039-2046. doi:10.1001/jamainternmed.2013.9763.

SLIDE 4

Monitor indoor conditions in 10 patient rooms and 2 nurse stations Map bacterial communities in these spaces Track patient HAIs

To better understand transmission, a 13 month study

n indoor air quality, bacterial spread & patient HAIs

was performed

Colonization and Succession of Hospital-Associated Microbiota. In Press, Sept 2016 Simon Lax, et.al. U.Chicago, IL 60637

SLIDE 5

Indoor air RH was found to be the most significant factor associated with patient HAIs

Av Avg RH for al all p pat atie ient r rooms

Colonization and Succession of Hospital-Associated Microbiota. In Press, Sept 2016 Simon Lax, et.al. U.Chicago, IL 60637

SLIDE 6

Dry indoor air shrinks aerosolized droplets, promoting pathogen transmission

100 10 3 0.5 1 41 hours 6 seconds 1.5 hours

Droplet diameter in microns (um) Float time

10m+ 1m Distance t nce travel elled ed:

SLIDE 7

Scofield - Sterling diagram published in 1985, with

ptimal RH level for health of 40%–60%

SLIDE 8

Viability of many pathogens is reduced in air with RH 40%–60%

7 23 33 38 43 57 74 10 20 30 40 50 60 70 80 90 10 20 30 40 50 60 70 80

Vir irus-Viabili lity ( (%) rel. Hu Humidit ity (%)

Humidity above 40% inactivates ≈ 80%

f Influenza Viruses within 15 minutes

High Humidity Leads to Loss of Infectious Virus from Simulated Coughs. U. Illinois, 2013 J Noti, et al.

SLIDE 9

Projected financial impact of room air humidification for a 250-bed hospital

SLIDE 10

Next steps for healthy humidification in your hospital

4

Install appropriate humidification systems

Energy efficient
Hygienic

3

Identify weaknesses in building envelope and HVAC systems

Look for areas which can be improved
Consult healthcare humidification experts

5

Continue monitoring both indoor air RH and patient outcomes

Assess impact of proper indoor air hydration on patient outcomes and length of stay
Perform ROI analysis

1

Monitor indoor air quality throughout the facility

A key starting point is understanding existing indoor RH and how it varies throughout

the hospital

2

Record HAIs

Accurately monitor patient adverse events, especially HAIs