Inspire | Healthcare: Announcing Our 2016 Richard M. Smith Leadership in Quality Improvement Award Finalists

The 2016 Inspire | Healthcare Awards have been designed to correspond to the Four Pillars of our work: Collective Impact, Program Management, Professional Services, and Innovation. For the Program Management category, we developed the Richard M. Smith Leadership in Quality Improvement Award to recognize an individual or team that has identified an opportunity to improve patient care and safety, and applied the PDSA (Plan-Do-Study-Act) principles of quality improvement to develop a successful intervention. Nominees must have demonstrated measurable improvements in the Triple Aim areas of healthier people, better care, and smarter spending. Their work should center around a clinical or non-clinical project that impacts patient care and/or experience. Examples include: medication management, falls prevention, infection control, emergency preparedness, care transitions/warm handoff, access to care, care management, or complex disease management. Eligible nominees must be members or customers of The Health Collaborative.

Finalists for the 2016 Richard M. Smith Leadership in Quality Improvement Award are:

Council on Aging of Southwestern Ohio (COA): COA has been nominated for its transformative work developing our region’s Care Transitions innovation. In the five years since receiving one of the nation’s first federal contracts to create and implement this innovation, COA and its partners have delivered an outstanding success story that has achieved national recognition for reducing hospital readmissions among at-risk seniors. COA’s Care Transitions is a health coaching, intervention and medical adherence program for older adults who have been hospitalized. It is designed to help frail seniors who have been discharged from the hospital avoid future preventable hospital admissions, and to help patients access appropriate post-acute medical care and home and community-based services. The program uses coaching, health information technology, help with medications, chronic disease self-management and connection to community resources to help hospitalized seniors get home and stay home. Positive outcomes of the program include: a growing patient volume (7,581 patients in 2015 compared with 6,236 in 2014); a high completion rate at 72%; medical adherence by most patients; reduced hospital readmissions; and reduced costs.

Linda Juengling, MSN, RN, NE-BC for the Level Two Huddle at Good Samaritan Hospital: Linda Juengling, Director of Nursing for Critical Care, recognized an opportunity to improve the identification and resolution of issues/problems related to the delivery of safe, timely and efficient care. Ms. Juengling developed the structure and format for the Level Two Huddle at Good Samaritan Hospital to communicate potential or existing safety issues facing patients and team members, increase safety awareness, and foster a culture of safety. Each hospital department conducts a Level One Huddle in their respective area to identify issues around patient care, safety issues, quality indicators, and a daily game plan. The Level Two Huddle then addresses concerns or barriers to patient care that cannot be addressed at the departmental level. Ms. Juengling demonstrated the urgency behind the need for this initiative. Due to her drive and passion for safety, she was able to generate excitement within the management team for the huddle. The Level Two huddle has identified potential and actual safety risks/issues, involving a systematic approach utilized to address and resolve issues. It also provides a well-structured and time-limited approach to preventing safety events and resolving process-issues leading to safety events/concerns. This demonstrates rapid-fire improvement in a coordinated and expedited approach, which did not occur prior the Level Two Huddle.

“Decreasing Obstetric Harm with a Patient Driven Protocol” team at the Mercy Health Family Birthing Center: It’s something many moms-to-be fear – vaginal tears that occur during labor. Ranked by severity on a scale of one to four, the worst vaginal tears cause pain as well as discomfort during sex and bowel movements for weeks. They can also lead to more serious concerns, including: pelvic organ prolapse, a condition in which the uterus, bladder and bowel fall into the vagina and may require pelvic floor surgery to repair; lifelong lack of bladder control; and lifelong lack of bowel control. A talented team of Family Birthing Center nurses at Mercy Health – Cincinnati, which provides advanced, quality, compassionate care in your neighborhood through its care network, wanted to spare their patients these issues and researched techniques they could employ to reduce the incidence of vaginal tears during childbirth. They succeeded in reducing the most serious third- and fourth-degree tears by more than half and also reduced pushing time by half.

Leadership Saves Lives Coalition at St. Elizabeth Healthcare: St. Elizabeth Healthcare joined nine other Mayo Clinic Care Network members in a groundbreaking study looking at how to reduce inpatient heart attack deaths by influencing organizational culture. Leadership Saves Lives was a two-year project initiated in mid-2014 involving health systems across the country. Recognizing that heart disease is the leading cause of death in the United States for both men and women, the study’s goal was to learn how patients, family members, emergency medical technicians, emergency room personnel, physicians, nurses, pharmacists, healthcare administrators and others can collaborate to provide the best care and best outcomes possible. St. Elizabeth is the only health system in the state and region participating in this study, the first of its kind to look at how organizational culture affects patient outcomes. St. Elizabeth began Leadership Saves Lives Initiative in 2014 with an impressive mortality rate of 4.5% (well below the national mean of 5.68%), and in 2015, the mortality rate at St. Elizabeth decreased further to 3.7%. By raising awareness and focus on this issue throughout all levels of the health system and the community, St. Elizabeth is leveraging all resources toward a single goal of reducing heart attack mortality.

“Reducing Falls and Restraints on a Senior Behavioral Health Unit” team at TriHealth’s Good Samaritan Hospital: Fall rates and restraint times on the Senior Behavioral unit at Good Samaritan Hospital were above targets set by the National Database of Nursing Quality Indicators (NDNQI) and were at all-time highs within inpatient units at TriHealth. The staff worked on the implementation of a private observation room that promoted a relaxing environment using aromatherapy, relaxing music, and no over-stimulating activities. The patients could use the sensory stimulation activity cart and receive therapeutic one-on-one interaction by an observer while being restraint free. These strategies not only reduced falls and restraint times when implemented, they provided patients an improved quality of life. In addition, the results demonstrated decreased length of stay and overall hospital costs. This project demonstrates the passion that staff on the Senior Behavioral Unit have for this specific patient population and the need to improve the health status of the people they serve.

“Maintenance Matters: Improving Patient Adherence to Adult Health Guidelines through Optimized Office Workflows” team at TriHealth’s Bethesda Family Practice: This group used multiple PDCA cycles (a modified rooming process and a patient check-in sheet) that focused on improving patient adherence to adult health maintenance guidelines. In the span of 1-year the percentage of patients undergoing the recommended colonoscopy, mammogram, diabetic eye and foot exams demonstrated significant improvements. Mean rooming time significantly improved from 7.09 to 5.74 minutes (p<0.05) by implementing a modified rooming process. This process change helped identify deficiencies prior to the visit by the physician. The Maintenance Matters project was the third place winner of the Richard M. Smith Quality Day’s Award at TriHealth.

“TriHealth Employees: Making “Sharp” Moves and Preventing Sharps Injury” team at multiple TriHealth facilities: This was a system-wide project that focused on decreasing the number of employee percutaneous injuries by 30% in 2015. It saw a 41% decrease in percutaneous injuries, demonstrated with the optimization of sharps equipment and the implementation of a hands free/Neutral Zone in the OR. In addition, education reinforced the practice of using a hands-free technique and a percutaneous injury board that displayed last injury brought awareness to the forefront.

Congratulations and good luck to all Richard M. Smith Leadership in Quality Improvement Award Finalists!

Below is a gallery of photos taken at the 2016 Inspire | Healthcare Award Finalists Breakfast, held on September 14 at Bronte Bistro in Rookwood Commons. For more information about the awards and the Inspire | Healthcare event on November 2, please visit healthcollab.org/inspire.

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