Robert Bober, MD: Results of the Optimal Hospital Innovations

Strategic Alliance Partnership | <b>Ochsner Health System</b>

By applying research-supported practices, Optimal Hospital has increased patient sleep, improved HCAHPS scores, and decreased length of stay and readmissions.

The Optimal Hospital initiative at Ochsner Medical Center in New Orleans has introduced changes to hospital room design as well as hospital care practices. These innovations have included wireless vital monitors, later blood draws to allow patients uninterrupted sleep, red lighting for nighttime use, and copper-infused linens, handrails, and tabletops to cut down on the spread of infections.

Robert Bober, MD, Director of Nuclear Cardiology at Ochsner Medical Center, told MD Magazine® that the changes they have introduced are not miraculous, they just take advantage of existing technology and apply scientific knowledge. He added that the end goal is to bring the Optimal Hospital changes to all areas of the hospital— “it’ll be called the normal hospital,” he said.

Bober along with Richard Milani, MD, Chief Clinical Transformation Officer Vice Chairman, Cardiology, Ochsner Health System, and colleagues conducted a trial to compare the Optimal Hospital wing to a standard hospital wing. The study included 3425 patients randomized to an intervention wing (n = 1185) or control wing (n = 2240) of the hospital.

The investigators found that the interventions reduced length of hospital stay by 8.6 hours (P = .04). Additionally, 30- and 90-day readmission rates were reduced by 16% and 12%, respectively (both P ≤.02).

In speaking with MD Mag, Bober also addressed the specifics of how hospital rooms and experiences have been redesigned and the role that patient empowerment plays in Optimal Hospital.

MD Magazine: What results have you achieved with the Optimal Hospital changes?

Robert Bober, MD: What we've been able to achieve in a short period of time with 1 wing is—in that wing, compared to control arm that had the same degree of patient—we've increased the length of sleep per patient, increased HCAHPS scores, decreased hospital admissions at 30 and 90 days, and also decreased the length of stay by a little over 8 hours. We've decreased the length of stay just by doing these changes.

MD Magazine: Is copper susceptible to microbial resistance?

If you think about it, these are not miraculous changes, we've not reinvented the wheel, we've just taken things—technology that's existing and good science—and we've applied it to wings of the hospital. The current goal is we're starting to expand to other wings and eventually we'd like to see the entire system running on Optimal Hospital, which won't be called Optimal Hospital, it’ll be called the normal hospital—it's the new standard that that we'll be living by.Bober: Basically bacteria cannot live on copper. The way that an antibiotic tends to work is it targets a particular cellular mechanism and disrupts that cellular mechanism, so when you get a drug-resistant organism, it's because that organism has found an alternative mechanism. So, you have to hit it with multiple different drugs. Copper disrupts numerous cellular mechanisms simultaneously so it's—I will not say impossible—but it's very unheard of that an organism can develop all of those mutations simultaneously. To my knowledge—again I'm not an infectious disease expert—but copper is an extremely resilient method for decontamination and for not allowing doctors and nurses to spread contagion.