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Innovation Hero Finalist: Dr. Amir Mian, Arkansas Children’s Hospital

3 min read

Dr. Amir Mian
Arkansas Children’s Hospital
Little Rock

Over the past five years, new regulations governing prevention of a deadly form of infection in the bloodstream are saving both lives and money at Arkansas Children’s Hospital. In the process, the hospital has distinguished itself as being among the best in the nation combating these infections, according to a pioneering leader in the effort, Dr. Amir Mian.

“U.S. health care industry is at a crossroads,” he said. “There is renewed intrinsic need for adding ‘greater value’ and there are stronger extrinsic demands for ‘improving outcomes.’

“Innovative ideas, creative thinking and increased recognition of shared value has led to distinguished achievements of several large health care organizations across the nation. The key is to customize these ideas and utilize them according to local needs.”

In this case, the opportunity lies in reduced incidence of central-line associated bloodstream infection (CLABSI), a potentially lethal form of infection that is commonly the result of bacteria transported into the patient’s bloodstream via an infected catheter

Mian, a specialist in hematology/oncology at Arkansas Children’s Hospital, volunteered to lead the effort in 2007. The mission was simple: Look into the hospital’s protocols and suggest ways to reduce the instances of these infections, starting with the Pediatric Intensive Care Unit (PICU). Despite the admirable goal, the road to change was sometimes rocky.

“As is the case with any new practice introduction, some inherent systemic skepticism, resistance to change and efforts to sustain compliance with these practices have been the main challenges,” Mian said. “It needed a lot of commitment and dedication among the team which initially consisted of just two volunteers, myself and Carol Oldridge.

“Over the years, the team has expanded significantly to 10 members and evolved into a formal committee which has helped transform the landscape of hospital associated conditions (HAC) across ACH, especially in the realm of CLABSI among cancer patients.”

Two years into the effort, ACH joined the National Association of Children’s Hospitals and Related Institutions (NACHRI) Quality Transformation Network, a national collaborative to decrease CLABSI. By 2013, ACH was recognized for being ranked among the lowest rates of CLABSI in the nation, a feat repeated during the first half of 2014.

“With strategic implementation of these guidelines, ACH demonstrated sustained success, which has been a model for improvement,” Mian said. “The impact of these efforts have resulted in saving the lives of eight patients, preventing 85 CLABSI among cancer patients and institutional cost saving of almost $3.1 million over the last five years.”

Mian said the protocols are also paying ancillary benefits, especially as the health care industry evolves in response to reform and higher expectations from government and patients alike.

“The challenges for health care in general are its enormous inherent complexities and demands that are even more challenging with shrinking health care resources,” he said.

Highlights:

» In 2007, Dr. Mian volunteered to head a two-person effort to reduce central-line associated blood stream infection (CLABSI), a potentially lethal means of blood infection.

» By 2009, ACH had joined a national collaborative of hospitals focused on reducing CLABSI rates and by 2013 was ranked among the lowest CLABSI rates in the country.

» The hospital’s protocols are credited with saving the lives of eight patients, preventing 85 CLABSI among cancer patients and institutional cost savings of almost $3.1 million over the last five years.

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