Hot Springs, Rogers Named 'Exemplar'

July 21, 2011


Teresa Lambert, Executive Director of

Outpatient Services at St. Joseph's Mercy,

receives the award from Anila Hussaini,

project manager for the Institute for

Healthcare Improvement, on July 20.

Kathy Duncan of the Institute for

Healthcare Improvement, presents Michele

Stewart, Mercy Medical Center

COO/CNO with the award on July 21.

St. Joseph’s Mercy Health Center in Hot Springs, Ark., and Mercy Medical Center in Rogers, Ark, have been named an Exemplar Hospitals for the Project JOINTS initiative by the Institute for Healthcare Improvement, a national group that focuses on safe and effective health care.

Making the announcement along with IHI this week were representatives from the Arkansas Foundation for Medical Care and the Arkansas Hospital Association. St. Joseph’s Mercy and Mercy Medical Center are the first hospitals in the nation to receive the “Exemplar” distinction.

IHI’s Project JOINTS initiative is a federally-funded program designed to speed adoption of proven methods to prevent surgical site infections (SSIs) after hip and knee replacement surgery. Arkansas is one of five states participating in the first stage of this three-year project, which stands for Joining Organizations INTackling SSI.

It has allowed St. Joseph’s Mercy and Mercy Medical Center to reduce infection rates.

 “I can tell you that we’ve seen a profound change in our patients in the past year,” said Dr. Robert Olive of St. Joseph’s Mercy. “People are just getting up quicker. The quicker they are getting up, the fewer complications they have. It’s just a better program all the way around.”

Anila Hussaini, project manager for IHI, said St. Joseph’s Mercy and Mercy Medical Center are two of four hospitals that will be listed as an “Exemplar Hospital.”  

“We’re doing this in five states with 185 hospitals so you’re in the top few to receive this right now,” Hussaini said. “Thank you for all the work you’re doing and sharing it with us.”

Both Mercy hospitals are pleased to be part of such a select group.

“It’s always an honor to be recognized for a best practice because that means our patients are receiving quality care,” said Michele Stewart, Mercy Medical Center COO/CNO. “We are even more pleased that these best practices can be used as a teaching tool for other hospitals and that their impact can go far beyond our own hospital’s walls.”

Eighteen Arkansas hospitals are participating in Project JOINTS and each commits to implement the IHI Enhanced Surgical Site Infections Prevention Bundle, a set of five evidenced-based practices designed to prevent surgical site infections in patients undergoing hip and knee replacement surgery. Three of the five are based on newer evidence:

  • Patient bathing or showering with a special antibacterial soap for at least three days before surgery
  • Screening patients for the presence of Staph prior to surgery and treating those testing positive
  • Preparing skin at the surgical site with an antiseptic solution that contains alcohol 

Two of the five practices are based on more well-known SSI prevention practices:

  • Reliably giving the appropriate antibiotics to the patient before starting surgery
  • Avoiding shaving hair at the surgical site

“What makes an Exemplar Hospital is that you’re implementing all three parts of the bundle and you’re doing it in a way that’s providing care 95 percent of the time to these patients,” Hussaini said. “We’d love to learn from you and to share with other people so they can begin implementing these changes that you guys are at the cutting edge of.”

Faye Nipps, quality specialist for the Arkansas Foundation for Medical Care praised Mercy as a leader.

“It is truly amazing that you are in front for the curve. You were doing these things in this bundle before it was even required to do. We appreciate you for leading the way in the state of Arkansas and in the nation,” Nipps said.

Launched in April of 2011, Project JOINTS is focusing on hip and knee replacement surgery because infections following these procedures can be catastrophic for the patient and those caring for them.  Treatment can mean multiple surgeries, months of medical and physical therapy, prolonged periods of recuperation, and often considerable pain and sizeable out-of-pocket expenses.  For some, permanent disability and long-term financial problems are the results.

With over 1.1 million procedures done in 2008 (the most recent numbers available), knee and hip replacements are two of the most commonly performed surgeries in the US.  Depending upon patient risk, it is estimated that between 6,000 and 20,000 SSIs occur annually after these types of surgeries and the number is predicted to rise substantially in coming years due to an aging population staying more active.

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