Halving avoidable conditions acquired in hospital can free up to 10 per cent of ICU capacity quickly and potentially save one life for every hospital bed, says Richard Jones, President and Chief Strategy Officer C2-Ai
COVID-19 looms over healthcare globally and will continue to have an effect for years to come. However, there are ways to alleviate issues in countries suffering capacity shortfalls in hospitals, and to return to ‘normal’ as quickly as possible.While the rates of infection may be levelling off in some areas, and some countries are well advanced with their vaccination programme, there are many including India that are suffering severe capacity issues.
Hospital staff globally have done a wonderful job throughout this pandemic, showing their dedication and hard work at every turn, despite all the physically tough and emotionally exhausting challenges. Unfortunately, some patients contract conditions in hospital that are avoidable.
One common condition is hospital-acquired kidney injury (AKI). A study by researchers at University Hospital Southampton NHS Foundation Trust, found that AKI was a significant factor for COVID-19 admissions to ICU and deaths. AKI was present in 31 per cent of COVID-19 hospital patients, and the condition (along with Hospital Acquired Pneumonia, HAP) was associated with 27 per cent of admissions to ICU. The findings also showed that more than twice the number of COVID-19 patients with AKI died, compared to those without it.
Taking our performance in hospitals for this approach and working with Indian colleagues, we estimate that an Indian hospital could save one extra life per bed over a 12-month period through the reduction in cases of these avoidable conditions and increased availability for COVID-19 patients. There are also obvious benefits longer term in reductions in patients moving on to suffer from life-changing conditions such as Chronic Kidney Disorder.
Accurately assessing risk
Hospital-acquired AKI and Pneumonia (HAP) cause an average of six and eight additional days in hospital, respectively. They are also found to increase the risk of death in COVID-19 patients, with AKI in particular being highlighted as problematic in guidelines issued by the National Institute for Health and Care Excellence (NICE) in the UK.
C2-Ai’s COMPASS mobile app provides clinical staff with a tool for accurately assessing every individual patient’s risk of developing the conditions in hospital, so that appropriate action can be taken to prevent significant numbers of AKI and HAP cases, reduce admissions to intensive care, and decrease associated morbidity and mortality. To be clear, this is prevention of these conditions – not identification when they have been acquired by a patient.
No complex integration is required and the app can be downloaded and supporting assessments in minutes.
C2-Ai has been named by HealthcareUK as one of “10 Essential Digital Health Ideas for a COVID-19 UK National Response” in part because of this approach. This technology helps decrease patient morbidity and mortality but also reduces pressure on staff.
The Compass app from C2-Ai can be downloaded onto a smartphone and used by clinicians immediately, without the need to integrate or store data. The app can evaluate a range of comorbidities and circumstances more quickly than might be done manually, with guidance on how to treat the patient provided. It is being used and trialled by several NHS trusts, based on approaches that have worked to reduce these conditions in several countries already.
By assessing patients on admission for their risks of acquiring hospital-acquired acute kidney injury and pneumonia, the system supports clinicians with specific advice on care tailored to each patient – reducing the number of patients acquiring the conditions and so preventing harm and saving lives.
Based on data from healthcare organisations using this technology, it is anticipated that this preventative approach can reduce overall AKI levels by 50 per cent through significant reductions in hospital-acquired AKI and reduce Hospital-Acquired Pneumonia by a similar amount.
Preventing conditions from developing will always be quicker and demand less clinician time than treatment and, naturally, will be better for the patient.
In addition, by freeing up bed capacity – particularly in ICU – such measures would also help hospitals save money. The reductions in these avoidable conditions could reduce direct costs by $9m annually in some countries during ‘normal times’, save up to 500 lives per hospital and also free up to 1000 bed-days monthly (with up to 10 per cent of ICU capacity being freed). At a time when there is huge pressure on hospitals, these tools are clearly beneficial.
Contact Information:
r.jones@c2-ai.com