When the ICU team of Lincoln Medical and Mental Health Center won the award for Hospital-Based Services at the HHC’s Patient Safety and Quality Exposition for its pioneering work on decreasing mortality in severe sepsis, a life-threatening bacterial infection, few were surprised. The team has been achieving impressive patient safety numbers over the last few years.
The Intensive Care Unit (ICU) team of Lincoln Medical Hospital, which serves the South Bronx, has shown that by following established best practices, substantial patient safety results can be achieved.
Through the use of best practices, The ICU team at Lincoln Hospital has reduced hospital-acquired infections, decreased mortality in severe sepsis and septic shock and achieved good outcomes in treating stroke patients. In 2007, Lincoln Hospital went 9 months without a central line or ventilator-associated pneumonia infection and 10 months without a urinary tract infection. And over the last few years, the ICU team was able to reduce mortality in sepsis by nearly 50%.
"We adopted models of care which has been shown to have success in reducing mortality in the ICU," according to Raghu S. Loganathan, MD, Director of the Medical ICU and Stroke Center at Lincoln. "We did this by adopting a 24/7 Intensivist Model at Lincoln Hospital. The model allows us to maximize the care of critically ill patients by having specialists trained in this area determine the best care for each patient."
Intensivists are doctors who have received training in critical care beyond their primary residence and specialize in working in ICUs. It is estimated that more than 54,000 ICU deaths could be avoided nationwide if every hospital used the model. However, despite studies that show that it greatly improves the quality of care in a hospital’s ICU, less than 25% of ICUs in the United States use this model. In addition, Lincoln Hospital has 24/7 coverage by attending physicians on all inpatient units.
When a patient comes to Lincoln’s emergency room and is noted to be critically ill, there is an evaluation by the intensivist on duty who determines if the patient needs to be admitted to the ICU.
"Our centralized system allows us to utilize our resources and provide needed services to patients," according to Dr. Loganathan. "Appropriate triage at admission and early recognition of critically ill patients is one of the key components of our ability to have mortality rates below national averages."
Lincoln Hospital also excels in the timely treatment of stoke patients. Thrombolytic medications, or "clot blusters" have proven to be lifesavers to patients who have had strokes and heart attacks. Studies have shown that the faster stroke patients are admitted to the ICU and started on thrombolytics, the better their better chance of surviving a stroke and minimizing its devastating effects. Through its Stroke Initiative, that is directed by the medical intensivist, one hundred percent of eligible patients receive thrombolytic therapy. Lincoln Hospital has outperformed hospitals in New York State and across the United States in various performance measures.
Lincoln Hospital also has several exciting initiatives in progress including a Regional Hypothermia Center scheduled to open in July, a project initiated by the New York City Fire Department, and the introduction of a palliative care bundle in the ICU.