Serving approximately 14,000 Native Americans across a five-county area in western North Carolina, Cherokee Indian Hospital is a family practice-based hospital and clinic that has enforced strict protocols to prevent hospital-acquired Methicillin-resistant Staphylococcus aureus (MRSA). It has been so successful, in fact, that the organization has been environmentally clean from MRSA for 10 years. In April 2011, Cherokee was recognized by The Carolinas Center for Medical Excellence (CCME) with an “Award of Excellence” for its outstanding achievement to improving quality care.

“Cherokee Indian Hospital is the standard for quality care,” said Jeana Partington, BSN, RN, CPHQ, care improvement specialist at CCME. “The hospital is so dedicated to the native American population it serves that it does everything in its power to ensure it provides exceptional quality care, which includes implementing consistent standards and procedures to prevent the transmission of hospital-acquired MRSA.”

Cherokee participated in CCME’s Medicare-sponsored patient safety initiative to reduce the incidence of MRSA in hospitals. Partington worked closely with Doris Bonilla, CIHA/HIS, director of public health at Cherokee, on utilizing a Centers for Disease Control and Prevention (CDC) software program to track and collect data on multi-drug resistant organisms (MDRO), such as hospital-acquired MRSA. Cherokee voluntarily participated in the project so they could learn how to electronically track any identified MRSA events with CDC’s software. 

Bonilla said CCME met with her on site visits, provided resources, and has been thorough and quick to respond with requests for assistance, particularly with her questions on reporting requirements. “Jeana has been very helpful and always encouraging, very cheerful,” Bonilla said. “One of our goals at Cherokee is to be on the cutting edge of information distribution and reporting.”

Partington said CCME values the partnerships with all its participating hospitals and the lessons learned from them have been invaluable. High-performing hospitals, such as Cherokee, serve as mentors for hospitals that are struggling with hospital-acquired MRSA.

Some of Cherokee’s key precautions on MRSA prevention include the following: 

• Educate workers, as well as patient and family members, on how MRSA infections spread. At Cherokee, housekeeping staff are counseled on the importance of thorough daily cleaning using products that specifically kill MRSA.
 
• Obtain the full support of leadership and administration. At Cherokee, a physician champion reviews all policy changes and assists in maintaining Cherokee’s MRSA-free environment. The physician championed the need for physician orders for nasal swabs for all newly-admitted patients on the inpatient unit. Also, employees are required to follow the “air-tight” infection control policy implemented by the infection control committee. The hospital’s Information Technology department keeps digital certificates up-to-date and resolves computer issues quickly.
 
• Implement strict policies on cleaning with all touch surfaces. At Cherokee, disposable gowns, gloves, and food trays are used when a patient is in isolation. Pull cords over the inpatients’ beds and bathrooms are plastic and are wiped clean daily. Dietary staff are not allowed to enter patient isolation rooms. Lab supervisors developed policies and procedures outlining the process to test patients on admission who may have acquired MRSA in the community. This is in accordance with standards outlined by two accreditation agencies, The Joint Commission and the College of American Pathologists.

“The goal of every hospital is to not have any hospital-acquired MRSA events, and Cherokee has shown that it can be done and sustained over many years,” Partington said. “I applaud Doris Bonilla for her support of quality improvement. She has shown exceptional dedication to her role and responsibilities.” 

Recent data from the CDC has shown that even though MRSA infections in health care settings are declining, it continues to be a high national priority. For hospitals like Cherokee that are ahead of the curve, maintaining high standards will be key to its success. 

“Infection control is so desperately needed in the hospital environment where sick and hurting people come to heal,” Bonilla said. “It is important that our patients feel that we are offering them a safe haven for treatment and recovery from their health care problems. We need to get the message to them that we will always continue to do our part to create a safe environment for their care.”  
 

CCME PRESENTS COASTAL CAROLINA HOSPITAL WITH AWARD FOR EXCELLENCE
—Contributed by Sarah Stein, MPH, CCME Marketing Coordinator

CCME recently recognized Coastal Carolina Hospital with two awards for its quality performance achieved under the Centers for Medicare & Medicaid Services (CMS) 9th Statement of Work. 

The first award is for Coastal Carolina Hospital’s commitment to quality improvement and exceptional performance in successfully maintaining a record of no hospital-acquired MRSA infections during the three-year contract. 

The second award recognizes the hospital for achieving a rate of 100 percent on one or more core measures during the CMS Surgical Care Improvement Project-Heart Failure Initiative. 

“We appreciate Coastal Carolina Hospital’s hard work and dedication to making patient safety a priority and congratulates them on their successful efforts to improve health care quality,” said Lynn Martinez-Page, BSN, RN, CCME care improvement specialist.

CCME collaborated with Coastal Carolina Hospital, among other hospitals, on both projects as part of the CMS National Patient Safety Initiative designed to improve health care by improving performance and implementing processes and systems that will reduce patient risk factors. CCME worked with participating hospitals on developing innovative, evidence-based processes that are linked to safe, high quality outcomes for their patients.

CCME has worked to improve the quality of care provided to citizens throughout the Carolinas for more than 26 years. Under contract with CMS, CCME serves as the Quality Improvement Organization (QIO) in North and South Carolina. These contracts are performance-based and focus on improving quality of care services for more than 2 million people with Medicare living in the Carolinas. CCME works with care providers from hospitals, nursing homes, and physician offices to implement evidence-based practices. 

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