Clinical excellence and patient safety are critical standards at Billings Clinic. One method used to measure our clinical excellence (also referred to as quality of care), is by comparing our performance to state and national patient quality benchmarks.
Billings Clinic strives to effectively use proven methods to improve every aspect of care for all of our patients and measure our performance in many areas. Below are some of the key metrics we monitor to demonstrate our dedication to clinical excellence and patient safety.
Initial response for sepsis and septic shock designed to minimize time to treatment
- Critical lab levels now performed by nurses at the bedside in the Emergency Department.
- Standardized orders created to support best practice in Sepsis care.
- Concurrent review of all hospital sepsis patients and real-time feedback provided to physicians and APPs to support learning.
Billings Clinic tracks patients who experience an unplanned readmission to the hospital within 30 days after a previous hospital stay. This visit can be for any reason, not just associated with the previous visit.
We strive to make everyone that comes to Billings Clinic feel informed, heard and cared for. One of the tools used to measure this is HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) surveys. The following graphs are a visualization of nurse and physician communication in the hospital and physician communication in the clinic.
Health Care-Associated Infections (HAI) Prevention Measures
Clostridioides difficile (C. diff) intestinal infections
- Initiate Special Contact Precautions promptly for diarrhea
- Maintain Special Contact Precautions throughout duration of hospitalization if C. diff is confirmed
- Perform hand hygiene with soap and water for 20 seconds
- Disinfect high touch surfaces and patient environment
- Disinfect medical equipment after use with bleach based cleaner
- Ensure daily patient bathing or showering with soap and water
- If C diff positive, do not repeat testing as patients may remain positive for ≥6 weeks
Catheter-associated urinary tract infections (CAUTI)
- Insert only when absolutely needed – Consider external devices or intermittent catheters
- Perform excellent hand hygiene and use superb sterile technique for insertion
- Utilize two people to maintain sterile procedure
- Maintain a closed system
- Remember peri care every shift and as needed
- Keep catheter stable and below bladder to ensure drainage
- Remove catheter as soon as possible
No catheter is the best catheter
Central line-associated bloodstream infections (CLABSI)
- Perform excellent hand hygiene
- Utilize insertion checklist
- Utilize full sterile drape
- Verify dressings are intact and changed when wet or non-occlusive
- Replace and label dressings every 7 days and as needed
- Scrub the hub with alcohol
- Remove central line as soon as possible
Surgical Site Infections
- Implement perioperative glycemic control and use blood glucose targets less than 200 mg/dL in patients with and without diabetes
- Maintain perioperative normothermia
- Advise patients to shower or bathe (full body) with an antiseptic agent on at least the night before the operative day
- Perform intraoperative skin preparation with an antiseptic agent unless contraindicated
- Hair removal should be avoided unless hair interferes with surgery. If hair removal is necessary, clippers should be used instead of a razor
- Use of a waterless chlorhexidine scrub is as effective as traditional water scrub and requires less time
- Smoking cessation 4-6 weeks before surgery reduces SSI and is recommended for all current smokers, especially those undergoing procedures with implanted materials