Interventions reduce serious events 83% at one hospital
Executive Summary
A health system has reduced serious adverse events by 83% over five years. The improvement is the result of a system-wide quality improvement effort.
Hospital-acquired infections were reduced 62%.
The system achieved a 98% score in core measures from the Centers for Medicare and Medicaid services.
Patients can show the board of directors the impact of quality initiatives.
A five-year effort to improve quality has resulted in an 83% reduction in serious safety events at Vidant Health in Greenville, SC, along with several other achievements.
During the last five years, Vidant Health has outlined interventions to improve patient safety and quality that included board literacy in quality, an aggressive transparency policy, patient-family partnerships, and leader and physician engagement. Implementation of specific tactics associated with each approach occurred in the ensuing years, explains Joan D. Wynn, PhD, RN, CPHQ, chief quality officer with Vidant Health in Greenville, SC, which has nine hospitals, 70 physician practices, and ambulatory surgery and home health/hospice services.
Other achievements include a 62% reduction in hospital-acquired infections, a 98% optimal care in core measures from the Centers for Medicare and Medicaid Services (CMS), patient satisfaction ratings above 80%, and more than 150 patient advisors partnering with leaders, physicians, and front-line staff in safety and quality work.
A first step in the transformation was to ensure that the Vidant board of directors understood their fiduciary responsibility for overseeing quality in the system, Wynn says. To improve the board’s quality literacy, Vidant sent the board members on retreats, brought in quarterly speakers, and conducted educational sessions.
"We wanted them to know the questions they should be asking when we present the quality data," Wynn says. "They needed to learn to read the quality scores also. That way the board could drive the improvement and make sure we were hitting this effort throughout the system."
To improve the transparency of quality measures, Vidant developed a standard quality score card that is used in the same way across all venues from the bedside to the boardroom, Wynn says. Color-coded measures helped everyone quickly seize the meaning of the data.
"We also wanted to make that information transparent beyond our organization, so if you go to the website for any of our hospitals, you will find easy-to-understand data on compliance with best practices like handwashing and infection prevention, and also outcome data on the numbers of infections and falls," Wynn says. "That helped spur us to do our best, because we knew that data was going to be public, and we wanted it to be as good as possible."
Patient and family partnerships also were important in improving patient safety and quality. Each hospital has a position called the patient care advisor, non-healthcare professionals who sit on many key committees and provide guidance from a patient’s perspective.
"That involvement facilitates having patients tell their stories to our leadership team, to the board, and to employees," Wynn explains. "We have had patients or family members describe their experiences in our organization, and that is a very compelling way to engage the hearts and minds of our employees to keep them working on continuous quality improvement. Putting a face to the numbers on the quality score card really helps."
The first patient to tell her story to the Vidant board had suffered a surgical complication that led to an infection, eventually spending 90 days in the hospital.
"She told the board, when you look at those quality score cards, I’m one of those ventilator pneumonias you see there,’" Wynn recalls. "Putting a face to the data, reminding them that it is people and not just data, definitely had an impact."
- Joan D. Wynn, PhD, RN, CPHQ, Chief Quality Officer, Vidant Health, Greenville, SC. Telephone: (252) 847-1946. Email: [email protected].
