Seeing the forest and the trees

Seeing the forest and the trees

Transparency a key difference

If a health system wins a major national quality award, it must be doing something right, but also something different from other organizations, right? Ask one and likely at some point, a spokesperson will says something about focusing on the patient and striving to improve. But not everyone.

"What healthcare organization isn't patient centered?" asks Tamera A. Parsons, the vice president of quality and patient safety for Mountain States Health Alliance, a Johnson City, TN-based system that includes 13 hospitals in Tennessee and Virginia that won the National Quality Forum National Quality Healthcare Award. "What organization hasn't shown improvement in quality and safety while the whole nation is watching?

"I'm sure we did this because we have the right principles and processes. But I also think that we have found the value of integration. We have our guidelines and our processes and our people, but it is not about tasks, but about incorporating those values into everything at every level," says Parsons.

What does that look like? The organization has 10 patient-centered care guiding principles (for a complete list, see box, below). Number eight is that transparency is the rule when caring for patients. "It makes a lot of sense that the patient has to be informed at every step of the way about what we are doing, why, and what we expect to happen. But we take it further. We include the patient's 'VIP — very important person' in that transparency. We extend it throughout the whole system so that the scorecard data that I see is given to every single person who has an email address ending in msha.com. We share patient data with accounting and accounting data with nurses. And we put it all up on our website so that anyone can see it."

MSHA is spread across 29 counties in Virginia and Tennessee. Much of the terrain is rural, some rugged. But Parsons says despite the size and complexity of the geography, they work hard to spread the projects and programs that work. Still, deployment is an issue that they continue to work on. "I think that using the Baldrige Criteria for Performance Excellence [http://www.nist.gov/baldrige/publications/hc_criteria.cfm] is helping us do better. If we were perfect, we wouldn't need the criteria, but we aren't, so we do," she says.

The organization uses the Baldrige criteria as its business model, something that makes her peers in other systems start asking questions. "It is completely integrated into our organization. We start from the focus of the customer, not the focus of leadership."

Another thing the organization is doing that's different is focusing on population health management and accountable health. "We are making our focus managing the health of our population, not a single episode of care, and are creating a 10-year plan that focuses on that," Parsons says. "I don't know if it is unique, but there certainly aren't a lot of people doing that."

Parsons knows there is no destination when it comes to quality, but she feels that this has been a good year for Mountain States. Along with the NQF award, they were honored by Virginia's highest award for performance excellence, Senate Productivity and Quality Award Program for Virginia, an award that hadn't been given out to a healthcare organization since 2009.

For more information on this topic, contact Tamera A. Parsons, Vice President of Quality and Patient Safety, Mountain States Health Alliance, Johnson City, TN. Telephone: (423) 431-6111.