Saturday, August 13, 2011

MHA does CLABSI right

Here's a great step forward by the Massachusetts Hospital Association, a public presentation  of current data on the rate of central line associated bloodstream infections among its participating members. Here's the current chart:

Let's talk about what's good about this. First, the data are quite current, just a few months old.  Next, the monthly figures, which are subject to minor variations, are smoothed out with a three-month moving average, so you can see the trend.  Third, there are no punches pulled.  When the rate goes up, they say it.

Since each hospital knows it own rate, it can easily compare its progress to others in the state.  N0t for the sake of trying to attract more patients or for other kinds of marketing, but to act as a form of creative tension within the organization to do better. Now, that's the right kind of competition.


Barry Carol said...

I wonder to what extent the hospitals with below average performance reach out to those that are doing well for help with and insight into how their process might be improved. Are the high performing hospitals willing to provide such help or do they view their performance as a competitive advantage that should be kept proprietary? Can hospitals that need some help even find out which hospitals are performing the best?

Lynn Nicholas said...

Paul, thanks so much for your kind words, and for highlighting some of MHA’s strong work to support hospitals’ Strategic Performance Improvement Agenda (or “SPIA” for short) statewide.

Barry, Massachusetts hospitals are indeed assisting each other to boost their performance through the SPIA program. Our hospitals are not only national leaders in voluntary reporting of patient quality and safety information, they are committed to moving beyond public reporting and transparency to make measurable, concrete improvements in hospitals' performance. MHA’s board unanimously approved SPIA and is currently focused on three strategic performance priorities. Our goal is for Massachusetts hospitals to collectively:

• Improve Quality by reducing preventable mortality
• Improve Efficiency by reducing preventable readmissions
• Improve Safety by reducing central line-associated bloodstream infections (CLABSI)

Overall, under SPIA hospitals are not competitive (only aggregate results are posted); instead they cooperate to reduce rates of preventable events across the board, and we're seeing movement in the right direction.

Massachusetts hospitals participate in is something called the Comprehensive Unit-based Safety Programs (CUSP) specifically for CLABSI. Best practices, lessons learned and other information is exchanged in group learning sessions (co-hosted by MHA and The Massachusetts Coalition for the Prevention of Medical Errors), and also posted publicly on PatientCare Link (PCL), a hospital quality and patient safety website that MHA and MONE support jointly.

There are two other SPIA commitments with even more hospital engagement and multi-provider collaboration:

STate Action on Avoidable Readmissions (STAAR) – STAAR is a collaborative endeavor with 50+ hospitals and their cross-continuum teams that all share and learn via statewide calls, coaching and in-person presentations. The STAAR project’s results are also posted on PCL.

Mortality Learning In Network (M-LINK) – MHA developed a peer-based learning network for hospitals and other providers to identify best practices that are correlated to lowering mortality, adopt system supports that are used in high-performing organizations, and implement protocols to identify and appropriately treat high-risk patients.

To view a list of Massachusetts hospitals whose boards of directors have signed on to the Strategic Performance Improvement Agenda, click here..