Cleveland-based Health System Uses EHR Best Practices And Order Set to Decrease Hospital Acquired infections

Source: HIMSS Analytics    

The MetroHealth System consists of one acute care hospital and 17 ambulatory sites with nearly 500 attending physicians, close to 400 physicians in training, 1,200 nurses and 6,500 total employees. On an annual basis The MetroHealth System records about 1,000,000 ambulatory visits, more than 100,000 emergency department visits (Level 1 Trauma Center), and approximately 28,000 inpatient admissions. The MetroHealth System is a teaching affiliate of Case Western Reserve University School of Medicine and is the essential (public) healthcare system in northeast Ohio.

Local Problem Identified
An Acinetobacter (pathogenic bacteria) outbreak occurred at the MetroHealth System.  The CDC describes outbreaks of Acinetobacter infections as ones that “typically occur in intensive care units and healthcare settings housing very ill patients.  Acinetobacter can live on the skin and may survive in the environment for several days. Careful attention to infection control procedures, such as hand hygiene and environmental cleaning, can reduce the risk of transmission.” 

Solution Enacted
A multidisciplinary team of administrative, operational, clinical, and technical staff began planning for MetroHealth System’s hospital-focused electronic health record implementation in the mid-1990s. MetroHealth began to install an EHR in the ambulatory settings beginning in 1999. Between 1999 and 2002, MetroHealth installed its EHR outpatient scheduling module, registration, billing and clinical care (documentation and ordering) modules in all of ambulatory sites. In 2004, MetroHealth installed an emergency department module. In 2009, MetroHealth installed an inpatient pharmacy system and converted all of their inpatient clinical care areas to the same EHR. In 2011, MetroHealth activated its EHR’s health information exchange, personal health record, and e-prescribing modules. In 2013 MetroHealth implemented bar code medication administration. In 2014, MetroHealth transitioned its  operating rooms to the system, as well as their anesthesiology and laboratory information systems.

Amongst many outcomes related to their efforts, MetroHealth was able to use electronic health record-based tools in support of the Acinetobacter outbreak. In conjunction with other efforts, these tools decreased the incidence of Acinetobacter in hospitalized patients by more than 60%.

Facility State/Region: OH
Facility Country: United States
Award: EMRAM Stage 7, 2015
Award link:
Sub Classifications: Treatment-Quality: Reduction in Hospital Acquired Infections 
Facility Type: Health Care System
Citation: HIMSS. (2015).  MetroHealth: HIMSS Analytics Stage 7 Case Study   Accessed July 19, 2017.