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Thermal Scans Help HHC Achieve Leapfrog “A” Ratings

February 05, 2024

For Lisa Corbett, the data wasn’t really making sense. Why were patients experiencing pressure ulcers within their first week of admission? Corbett, DNP, APRN, system director of clinical wound care for Hartford HealthCare, knew from her years of experience that these injuries (referred to as bed sores in layman’s terms), should only be presenting during longer patient stays. “For 20 years pressure injuries have been one of the highest-profile patient safety outcomes we measure,” she notes. “We have all kinds of best practices and precautions in place. We are hard-wired for those protocols in our nursing care.” Her team went deep into the information behind the numbers. “The data showed that these patients were showing signs of pressure injuries very quickly after admission,” she says. Her research resulted in an understanding that for many of these patients, they were ill and largely immobile at home for some time before their hospital admission. “So, the question became was (the injury) brewing under their skin all along or was it caused by our care?” Corbett and a team of nurses looked to see what technology was available to identify these at-risk patients on admission. There were two options: one that looks for edema (swelling) under the skin, and one that performs a thermal scan to identify areas of temperature differences under the skin. The unit-based nursing group at Hartford Hospital, known as the “Skin Champions” for their work to prevent pressure injuries, researched the two technologies and decided to test thermal scanning in the hospital setting. From there, they did a three-month trial in the ICUs at Hartford Hospital and the Hospital of Central Connecticut in 2021, adding thermal scanning to admission testing of each patient upon arrival. They found a significant number of patients who had differing temperatures under their skin, and when they implemented best practices immediately, they saw a reduction in the number of pressure injury cases. “We developed the protocol and wrote a grant application and all eight ICUs at Hartford Hospital were able to get the scanners. We provided training on the equipment and the protocol.” There was more success in the reduction of pressure injuries, and in June 2023, all Hartford HealthCare ICUs received the scanners and training. Thermal scanning of heels and buttocks – the most prone areas to pressure – is now part of the ICU admission process. “These deep tissue skin injuries can occur up to seven days before it shows up visually,” Corbett says. Since June 2023, there have been 33 “saves.” This means there were 33 patients who showed thermal abnormalities on their admission scan, which meant preventive strategies were implemented quickly. “That’s phenomenal,” Corbett says. Each such reported injury has a $45,000 fine attached, so that’s a savings of $1,485,000. The reduction in the instance of pressure ulcers also helped Hartford HealthCare’s hospitals all receive “A” grades from The Leapfrog Group, the nation’s leading independent watchdog for analyzing safety and quality data. Very few health systems in the nation have ever achieved straight As for safety. The Leapfrog Group noted that HHC’s efforts to reduce the instance included:

  • Thermal scanning technology to spot skin breakdown before it’s visible.
  • Standard protocols directing teams to assess skin condition at admission and periodically during hospital stays.
  • Creation of a nursing council to teach clinical teams how to avoid pressure ulcers and help patients who develop them.