ADVANCE for Executive Insight 1 ADVANCE for Executive Insight

VAP
Cost Implications of VAP
An equation developed by Johns Hopkins helps administrators quantify potential savings by
reducing hospital-acquired infections. By Gail O. Guterl
advance
peer
reviewed
PR
Gail O. Guterl is an editor and
freelance medical writer.
It would be utopia if quality patient care was
the only engine driving healthcare today.
The reality is a facility must generate profit
to keep its doors open. But what if you could
do both?
Some expenditures can’t be avoided, but reducing
hospital-acquired infections could be a
big cost saver — especially now that the Centers
for Medicare and Medicaid will not reimburse
for many of these preventable complications.
One of the most common hospital-acquired
infections is ventilator-associated pneumonia
(VAP), affecting about 250,000 people annually.
It is also one of the most expensive, costing anywhere
from $12,000 to $40,000 to treat one hospital
case and with a 60 percent mortality rate. 1,2
Each year in the U.S. a conservative estimate of
collective VAP infections costs a whopping $3
billion.
Any way you approach it, reducing VAP could
markedly impact the bottom line and, most importantly,
improve patient care.
PROBLEMS & SOLUTIONS
Understanding the problem is the first step to
elimination. VAP is defined as pneumonia that
occurs more than 48 hours after a patient has
been intubated and has been receiving mechanical
ventilation. For every day on a ventilator, the
risk of VAP increases from 1 to 3 percent, said
Sean M. Berenholtz, MD, MHS, FCCM, physician
director of Inpatient Quality and Safety,
Armstrong Institute for Patient Safety and Quality,
Johns Hopkins Medicine, Baltimore.
Before expensive treatment for VAP can even
begin, diagnosis itself can be costly, including
aggressive patient surveillance, bedside examination,
X-rays and laboratory analysis of respiratory
secretions.
Believing prevention is achievable, researchers
at the Armstrong Institute decided to tackle
the issue head-on. The result: a five-point initiative
that has virtually eliminated VAP in numerous
hospitals, including 65 Michigan facilities
that were part of the Keystone ICU project
ADVANCE for Executive Insight
31