Thursday, May 26, 2011

Is it something in the water?

What's going on in Michigan? There seems to be something about that state that prompts sustained and excellent progress in improving the quality and safety of patient care. Here are two announcements from Diane C. Pinakiewicz, President of the National Patient Safety Foundation. Let's bottle that water and send it around the world!

The National Patient Safety Foundation (NPSF) today awarded its 2011 Chairman's Medal to Dr. Robert Connors, president of Helen DeVos Children's Hospital, a member of Spectrum Health System in Grand Rapids, MI.

Beginning with the stated goal of creating "the safest children's hospital in America," Connors spearheaded a patient safety program in 2007 that empowered staff by removing traditional hierarchies and barriers to communication. After completing an intensive training program in safety sciences and armed with error reduction tools and techniques to guide their practice, employees directly involved in patient care gained the authority to raise safety concerns with anyone at anytime. Connors' efforts at the hospital resulted in this program being picked up by the entire Spectrum Health System organization, which includes nine hospitals and 180 care sites.

Among the outcomes:
  • Between 2008 and 2010 safety events were reduced 68 percent.
  • Ventilator associated pneumonias in the Pediatric Critical Care Unit have been eliminated for 19 consecutive months.
  • Hand hygiene has improved from 56 percent to 96 percent for more than a year, helping to reduce hospital acquired infections by 50 percent.
  • Catheter associated blood stream infections in the Newborn Intensive Care Unit were reduced by almost 50 percent.
  • Asthma core measures at discharge achieved 100 percent compliance.
  • Spinal surgery infections were eliminated.
Sustaining the safety transformation has become just as important as launching the initiative. "Safety is now an integral part of our strategic planning and daily operations," said Connors. "We have appointed an executive director of quality and safety, created unit based safety champions and forged partnerships with other leading children's hospitals engaged in safety work best practices."

And . . .

The National Patient Safety Foundation (NPSF) today awarded its 2011 Stand Up For Patient Safety Management Award to Franciscan St. Anthony Health-Michigan City, a member of the Midwest-based Franciscan Alliance.

The Patient Safety Management Award is granted to a member hospital of the National Patient Safety Foundation’s Stand Up for Patient Safety program in recognition of the successful implementation of an outstanding patient safety initiative led or created by mid-level management. The initiative must have demonstrated evidence of patient safety improvement, with involvement of staff at all levels of the organization.

The hospital’s Nuclear Medicine Department designed a process-improvement project to study its lymph node visualization rates. The mammary sentinel lymph node biopsy, or sentinel nodal location (SNL) procedure, plays a critical role in the staging of breast cancer, and information from the biopsies is used to determine how to treat the cancer most effectively. In a study involving 24 patients, health professionals at Franciscan St. Anthony Health-Michigan City found that by reducing the length of the needles used during the biopsies, visualization rates improved dramatically, from 25 percent to 100 percent in 2010.

By optimizing its visualization rates, the hospital has improved the quality of care and safety of its patients by:

· Reducing patient discomfort associated with the SNL procedure

· Reducing surgical time (total procedure time reduced from 3 hours to 1 hour)

· Shortening recovery time

· Increasing access to outpatient surgery bed time (for other patients)


Anonymous said...

Ahem . . . Michigan City is in Indiana, not Michigan

Paul Levy said...

Oops. Do they share the same watershed?

Anonymous said...

Well, instead we can substitute the stellar results of over 90 Michigan ICU's in maintaining a reduction or elimination of catheter-related bloodstream infections for 2 years or more:

nonlocal MD

Anonymous said...

on the other hand, Michigan has a maternal mortality rate that is 26.0/100,000. This is at least 50% (and statistically significantly) higher maternal mortality rates than the national average (12.7).

Other states with higher than average include the District of Columbia, Oklahoma, Idaho, New Jersey, Maryland, New York, and Mississippi in addition to Michigan.

Paul Levy said...

My guess is that those would be population-based, i.e., public health related results, in contrast to the quality and safety metrics associated with hospital care.