Beyond 4 Eyes in 4 Hours Implementing Long Wave Infrared Thermography

Introduction: Early identification and prevention of Pressure Injuries (PIs) pose significant challenges in hospital settings. The incidence rate of Hospital Acquired Pressure Injuries (HAPIs) at San Juan Regional Medical Center was consistently higher than the 2022 benchmark rate set by the Agency for Healthcare Research and Quality (AHRQ) which signified need for further investigation and corrective action. Root cause analysis was conducted revealing multiple key factors that contributed to higher incidence of HAPIs including population of dark skinned individuals, inconsistent skin assessments, risk assessment tool completion variances, delayed preventative interventions, fragmented documentation, and organizational resistance to change.Methods:A dedicated interdisciplinary team was established to address issues and identify solutions. To reinvigorate the organization and move towards “zero” harm, “4 Eyes in 4 Hours” was merged with “Thermal Imaging” into a strategy coined “Beyond 4 Eyes in 4 Hours”. Long Wave Infrared Thermography (LWIT) aids the bedside clinician in early detection.  The merge illustrated the critical importance of timely assessment and early interventions. Other tools used included Six Sigma / Lean; Organizational Learning; System Thinking; Plan-Do-Study-Act (PDSA); Define, Measure, Analyze, Improve, and Control (DMAIC). Hospital leadership analyzed data, created a shared urgency, identified key stakeholders, and set “SMART” goals.Results:Results exceeded expectations. Within 2 months of implementation, our incidence of HAPIs reduced from baseline of 25.71 (per 1000 discharges) to 2.55. At the 6-month mark, our rate of incidence was 0.00. Our policy compliance is above 90%. SJRMC’s 6-month financial gain estimated at over $5 million dollars. Some key factors that contributed to project’s success included creation of customized staff and patient education tools; daily reports to unit management; monthly reports to quality, and routine meetings with internal team and vendor to build future growth. Discussion: Increased complexity in patient care is rising and requires healthcare systems to adapt and evolve to ensure the delivery of high-quality and safe care. Facilities should not be afraid to take big steps to improve care, demonstrate willingness to learn, and not underestimate clinical staff’s willingness to embrace new technology and change processes. SJRMC will continue going “Beyond 4 eyes in 4 hours” for successful outcomes.References: