Step aside, Blue

While I am usually not one to provoke intra-regional rivalries in health care, who can resist piling on in the age-old one between fans in Ann Arbor and Columbus?  My regular readers know that I have tremendous regard for the commitment made to quality and safety improvement by the University of Michigan folks, and I have often written about the progress in process redesign being made there.  But I have to report on an even more aggressive approach to these matters by an affiliate of the Ohio State University, Nationwide Children’s Hospital.

Stimulated in great measure by chief medical officer Rich Brilli, this hospital’s board has adopted a goal of eliminating preventable patient harm by 2013.  The hospital is now replete with “Zero Heroes,” a far flung team of clinicians, process engineers, and administrators who live every day focused on this effort.

Anamarie Rayburn (seen here with chief quality officer Rick MacLead, aka Medical Director for Quality Improvement Services) is one, chairing a daily huddle with senior administrators where they ask, “What safety problem have we encountered in the last day?” and who then focus on wiping out that problem before the next daily meeting is convened.  This and other approaches represent real-time process improvement, grabbing at every incremental change to fulfill the mission, “Create a safe day.  Every day.”  There is also a dramatic commitment to transparency, with key metrics posted on the hospital's public website.

The desire to eliminate harm does not just focus on the usual type of adverse events, the reportable and sentinel cases.  The hospital staff rely on uncovering problems indicated by near misses and early signs of harm.  For example, Nationwide is intent on eliminating pressure ulcers in their patients, so the nurses and analysts are tracking the precursors of such wounds, metrics that would not even be on the list of such matters for most hospitals.

I know of only one other hospital that has adopted the pursuit of this kind of standard of care, and that one (ahem!) was in a different region.  So the way I see things, the Buckeyes are now in the lead in the Midwest conference.  While it is great to see both institutions’ progress and commitment to improving patient quality and safety and to broad-based process improvement, we are still in the first quarter.  Not to put on too much pressure, but if “Hail to the Victors” is to mean anything, it is time to step up the game in Ann Arbor.  Let’s go Blue . . . .