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Ohio Hospital Association Learning from Patient Stories

Ohio Hospital Association Learning from Patient Stories. June 15, 2017. The Stakes …. Who Was Peggy ?. Peggy’s C. diff Story. Broad spectrum antibiotic following root canal Symptoms begin 5 days into course Suspected stomach virus Admitted to hospital 5 days after diarrhea onset

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Ohio Hospital Association Learning from Patient Stories

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  1. Ohio Hospital AssociationLearning from Patient Stories June 15, 2017

  2. The Stakes…

  3. Who Was Peggy?

  4. Peggy’s C. diff Story • Broad spectrum antibiotic following root canal • Symptoms begin 5 days into course • Suspected stomach virus • Admitted to hospital 5 days after diarrhea onset • Died 36 hours later

  5. Lessons from Peggy’s Story • Lack of C. diff Awareness • Persistence of C. diff Myths • Antibiotic Overuse (Prophylaxis) • No warning from dentist • Danger of Prescribing Imodium

  6. Learning from Patient Stories With C. diff changing, patient experiences: • Humanizes statistics • Breaks through C. diff mythology • Illustrates challenges and opportunities in infection control, prevention, public education, transparency and treatments • Highlights opportunities for collaboration

  7. AprylGleespen • Healthy 59 year-old from Akron with recurrent UTIs • Given 3 different antibiotics in a 2-month span • Failed Flagyl and Vanco, surgery was suggested • Saved by fecal transplant via nasal-gastric tube Lessons • Polypharmacy can occur with antibiotics • Current treatments remain insufficient for some patients

  8. AndiL. • 4 year-old from Zanesville started with vomiting and diarrhea • No recent antibiotics usage • Pediatrician initially dismissed C. diff due to age • Multiple courses of flagyl eventually resolved infection Lessons • Every year, 17,000 children get C. diff infections in the US • CDI can occur without recent antibiotic usage

  9. MaryAnn Dillon • ER Nurse for 25 years • Atypical C. diff presentation • Worked with Peggy’s sister • Peggy’s story was impetus for MaryAnn to request C. diff test • C. diff cost her 3 months of work Lessons • Healthcare Workers are at risk • Personal stories resonate

  10. PLF’s Work • Awareness Raising & Education • C. diff Stories • PSA, Website and Social Media • Hospitals, QIOs, Agencies • Advocate Training • Amplifying Our Work Locally • HAI Committees, Hospitals, Media • Policy Advocacy • Increased Funding for ARO • Increased Surveillance/Reporting

  11. Moving Past Blame… Cycle of Blame

  12. C. diff is changing • 1 patient with C. diff dies every 5 minutes • 5 patients are diagnosed with C. diff every minute • Infections rates have doubled since 2001 • 10% of patients colonized at admission • 50% of cases are community-acquired • Strains increasingly virulent and deadly • Previously, low-risk populations (post-partum women, children, etc.) are getting C. diff • CDC now classifies C. diff as an “urgent threat”

  13. Tip of the Iceberg 29,000 deaths according to CDC 109,000 deaths 2008 Prevalence Study Nursing Home Deaths (Unreported) Community Deaths (Unreported)

  14. We have the knowledge & technology… • We know how to minimize transmission in hospitals • High degree of hand washing and sanitation compliance • Vigorous environmental cleaning coordinated with Infection Control • Active detection and isolation of suspected carriers • Antibiotic stewardship • Education of patients and visitors • New technologies from more sensitive tests to UV cleaning technologies are emerging regularly • Too often the missing ingredient is the will to change

  15. All Hands on Deck! • C. diff is a complicated public health issue with several direct and indirect causes • It requires nuanced, manifold approaches • Intra-hospital and inter-facility • Public awareness • Treatment and prevention development • We all have a role to play

  16. Working Together

  17. “All you have in this world is each other.”

  18. Peggy’s Vision A World Where C. diff is Rare, Treatable & Survivable.

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