South Carolina Hospital Association: Rewarding a Culture of Safety

When it comes to infection control, the South Carolina Hospital Association (SCHA) has really taken to heart the ironclad medical principle: First, do no harm. The slow and steady reduction in the rates of central-line associated bloodstream infections, (CLABSI), surgical site infections (SSI), Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile infections (CDI) across the Palmetto State’s hospitals was kick-started by the launch of the Certified Zero Harm program in 2014. This innovative program recognizes South Carolina hospitals that are on the forefront of preventing medical errors.

The Certified Zero Harm Awards began with a core idea: Zero harm as a goal was possible in a highly reliable system. SCHA began rewarding hospitals and health systems that went extended stretches free of health care-associated infections in common categories and procedures.

While challenges due to the COVID-19 pandemic disrupted organizations’ progression in meeting national reduction targets by the end of 2020, South Carolina hospitals have regained their momentum and are once again on track — and ahead of the national curve — in achieving reduced rates of infection.

In 2022, 60 of SCHA’s 100 hospitals received a total of 325 awards for achieving “zero harm.” This translates to:

• 204,475 infections avoided 
• 5,839 surgeries performed with zero harm 
• $6.16 million in projected savings 
• 117,532 central line days with zero harm 
• 1,772 hospital days avoided   

The progress began with using the Joint Commission Center for Transforming Healthcare’s self-assessment tool, Oro™, to help hospitals across the state develop individualized plans toward zero harm goals. The customized plans are guided by a Zero Harm Blueprint that lays out benchmarks focusing on six key domains: vision for safety, trust and respect, board engagement, leadership development, just culture, and behavioral expectations. The six domains of the blueprint come with specific scoring metrics that define a hospital’s achievement in that area and instruction for additional improvement. In addition, SCHA hosts webinars throughout the year for hospitals to learn more about quality and best practice strategies.

The state hospital association’s laser focus on improving safety and reducing infection rates have been rewarded by hospitals and health systems across the state achieving 12, 18, 24 and even 45 months of harm-free stretches. After 10 years and despite the challenges of the COVID-19 pandemic, over two-thirds of SCHA members have now won at least one Zero Harm Award.