May 23: Clinical Performance Measures
Reliability. Such an important concept in health care. How do we develop systems to ensure that every patient receives the right care for the right reason at the right place every time?
Last night, I was reviewing our performance in key clinical indicators, as listed above. Basically, patients expect to receive effective, safe, patient-centered, timely and efficient care. So, how does a patient know they actually received effective and safe care?
Most patients of course don’t have the expertise to be able to judge whether the care they received was appropriate or safe. Isn’t it our responsibility to demonstrate that to our patients?
Today, of course, hospitals throughout the country are required per CMS to report on their clinical outcomes and, increasingly, payment follows performance.
I am proud to say that here at BGSMC, under the leadership of Chief Medical Officer Dr. Paul Stander, our medical staff leaders and our nursing leaders, as well as the focus from everybody on our care team, we have learned how to create systems that reliably deliver the right care at the right time.
If you look at this list and ask yourself, "Shouldn’t 100 percent of our patients with Heart Failure receive discharge instructions? Shouldn’t our patients with an acute myocardial infarction (heart attack) receive a primary Percutaneous Coronary Intervention (coronary angioplasty) within 90 minutes?" Of course!
But the fact is, if I asked every single individual who works every day at BGSMC if they are trying hard every day to give the recommended care 100 percent of the time, the answer would of course be, “Yes.”
But, as all know, the fact is, every system is designed to get the result it gets.
So how do we work together to design highly reliable systems to prevent every fall and every central infection? How do we make sure every heart failure patient receives the appropriate discharge instructions? How do we make patient receive a blood transfusions only when appropriate? And how do we prevent every avoidable readmission?
Working harder is not enough. Instead, our focus should be about aligning our structure, strategy and systems to create a culture of continual improvement. Fortunately we’re a Truven Health Analytics Top 5 Large Health System because of such outcomes, and we have the tools and resources from Care Management (through the work of the Clinical Consensus Groups and Discipline Groups that many of you participate in) to help us continually improve.
Our focus is not about hitting targets. It is about applying the concept of rapid cycle improvement to improve. With that philosophy, BGSMC will remain a Place of Possibility for improvement, where everyone comes to work focused on contributing toward that vision.
Today at BGSMC I know that there are quality improvement projects being conducted as I write this.I know there are safety events you are reviewing and learning from them every day. I know you are analyzing how to improve the length of stay in your unit or understand your gap in patient experience scores and the latest readmission, fall, and central line infection rates.
However, the question is, do we have a reliable structure and strategy so that we are breaking silos, sharing secrets and collaborating to create an incredibly robust culture around patient safety and quality improvement, where we engage the entire team, including our patients in this journey?
I look forward to working with many of you to design safer and more reliable systems at BGSMC. As we continue to grow and differentiate our clinical programs and invite patients all over the country to this Place of Possibility, I know with your commitment and leadership, we will continue towards our journey of Continual Improvement.
And making sure that with the right systems in place, every patient continues to receive the right care at the right place for the right reason every time.
Steve Narang, MD, is the chief executive officer at Banner Good Samaritan Medical Center.