Kaiser regional division adapts quality approach under COVID-19

The new environment COVID-19 created presents challenges for health systems to maintain quality, and some health systems have adopted well.

Take for instance Kaiser Permanente Northern California, which includes 21 hospitals in addition to a health plan with 4.4 million members.

The health system recognized early that it was harder to prevent falls and other hospital-acquired conditions during the pandemic because of restrictions on loved ones visiting and limits on frequency of staff entering rooms of COVID-19 patients to conserve personal protective equipment.

“We noticed there were some conditions we needed to pay attention to in a different way,” said Robin Betts, vice president of quality, clinical effectiveness and regulatory services at Kaiser Foundation Health Plan & Hospitals, Northern California.

For instance, when Kaiser recognized that falls were creeping up at the beginning of the pandemic, the nursing staff increased its communication with patients about the importance of asking for help before getting up, particularly for those at high risk for falling. Nurses, who visit patients at least once every hour, also encouraged patients to use the restroom when they entered the room.

Similarly, preventing pressure injuries became more of a challenge during the pandemic for some patients, Betts said. COVID-19 patients on ventilators and proned, which is when patients are placed on their stomachs, were susceptible to pressure wounds from devices. In response, Kaiser enhanced training on proned patients, emphasized the use of cushions and dressings on areas at high risk for sores and began removing or readjusting devices daily.

Betts said COVID reinforced standard quality practices that work but also showed “there are enhanced opportunities we need to deploy to sustain and continue to reduce harm in our organization.”