OCA Hospital, Monterrey, Mexico

OCA Hospital is the largest private hospital in Monterrey, Mexico, with 290 beds. CEO Dan Levinson is enthusiastic in describing the many improvements made at his hospital during their pursuit of JCI Accreditation.  JCI accreditation was awarded in November 2008.




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Situation

Fostering a culture of quality and patient safety has been a priority at OCA Hospital for some time. In 2003, OCA Hospital was certified in ISO 9001 and in 2007 the hospital earned the State Quality Award, which is based on the Malcolm Baldrige Model.

According to Mr. Levinson, OCA Hospital sought to achieve JCI Accreditation because it is  “a health care-specific organization with health care-specific standards.” Mr. Levinson admits, however, to being “astounded” when they began examining the JCI standards. “We were not complying with several of them. It was only then that we realized that we needed JCI Accreditation to become a better and safer place for our patients.”

Results

Health Care-Associated Infections

OCA Hospital achieved some of its most impressive improvements in the rates of nosocomial infection in the ICU.  A task force was formed that revamped infection control policies and implemented a quality assurance program that included both internal audits and training of personnel. As a result, the staff greatly reduced infection rates for both adult and pediatric patients. “This project’s conception came as a result of working with JCI and trying to incorporate its philosophy of teamwork and patient safety,” said Mr. Levinson. “The project started with specific goals and activities and ended up creating a new way of communicating and collaborating between people and departments.”

Infection rates for adults in the ICU fell from 6.60% in 2007 to 3.75% in 2008. The infection rates for infants in the NICU fell from 19.5% to 8.44%. Ventilator-associated pneumonia (VAP) infection rates per 1000 days were reduced from 22 to 7.84, a 64% improvement. The VAP per 1000 days in the NICU decreased from 16 to 3.33.

“We have not had a single VAP in the last 5 months in both units,” reports Mr. Levinson. “The overall hospital infection rate was already low before we started this project, and we still were able to bring it down some more, from 1.6% to 0.70%. This is considerably lower than the average 2% that some of the best hospitals in the world have.”

Myocardial Infarction

OCA Hospital staff also made substantial improvements in their process for handling heart attack patients. Their primary goals were to reduce the time it took to administer drugs and other procedures and thus reduce the mortality of heart patients. In 95% of cases, caregivers administer aspirin and conduct an EKG within the desired time frame, and the hospital has reduced by 50% the amount of time it takes for a patient to receive an angioplasty after admittance. “Af ter 8 months of implementation we can safely say this project has been a success,” said Mr. Levinson.

Prior to achieving JCI Accreditation, OCAHospital had a reputation within the community for delivering health care with the “highest quality standards,” according to Mr. Levinson.  Achieving JCI Accreditation has further “enriched our operations” and brought about a change in mindset among staff. “Seeing our staff eradicate old paradigms about the impossible and the unreachable has been an inspirational experience. We feel very proud about the people in our organization and we believe in their commitment to stay in this path,” reports Mr. Levinson. “We feel proud about the fact that our patients recognize this positive change, and express positively about it in their surveys, improving our customer satisfaction indicators.”