Quality Improvement in Long-Term Acute Care Hospitals (LTACH)

According to the Centers for Disease Control and Prevention, at any given time, about 1 in every 20 hospitalized patients has a healthcare-acquired infection (HAI), and more than 1 million HAIs occur every year. Although these data are specific to acute care hospital patients, HAIs can occur in any healthcare setting, including LTACHs.

About the Project

Quality Improvement in Long-Term Acute Care Hospitals is a Special Innovation Project (SIP) that convened a Learning and Action Network (LAN) of participating LTACHs interested in improving care while reducing infection. Quality Insights provided the LAN participants with:

  • Best practices from current and past Quality Improvement Organization program HAI projects
  • Proven educational tools and resources
  • Evidence-based guidelines
Quality Insights and the participating providers worked together to improve the quality of healthcare provided to Medicare beneficiaries by reducing HAI rates at the participants' facilities. The first phase of the project focused on improvements in 16 Louisiana LTACHs in calendar year 2016.

Throughout 2017, Quality Insights spread best practices and lessons learned to LTACHs in the other states we serve – Delaware, New Jersey, Pennsylvania and West Virginia.

The project’s educational approach included webinars and other focused training based on a needs assessment from root cause analysis findings. Where root cause analysis demonstrated an opportunity for improvement, Quality Insights used a three-pronged approach addressing hand hygiene, isolation precautions and ventilator-associated pneumonia.

To track success, Quality Insights monitored participants’ Standardized Infection Ratios for the following areas:

  • Central Line-Associated Bloodstream Infection (CLABSI)
  • Catheter-Associated Urinary Tract Infection (CAUTI)
  • Clostridium difficile Infections (CDI)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Ventilator-Associated Event (VAE)

In addition to provider education, Quality Insights recognizes the importance of patient and family engagement in improving healthcare. Our quality improvement activities, technical assistance, LANs, and educational materials focused on enabling patients and their families to participate in treatment and communicate with healthcare professionals. Project tools and materials included components that encouraged active patient and family involvement in preventing HAIs and reinforcing healthy practices after discharge.

As a result of providers following evidence-based practices to prevent healthcare-acquired infections, as well as engaging patients and families in proper hand hygiene education and creating a culture empowering patients to “speak up” on hand hygiene, patients in LTACHs benefit from a reduction in HAIs, which saves lives and healthcare dollars.

Project Contacts

Debra Rushing
State Program Director

Danielle Guidry
Quality Improvement Specialist

Infection Prevention Resources