Quality Improvement Projects
How TriHealth collaborates with others to improve quality
QUEST: High Performance Hospitals
Aligning Forces for Quality--Managing Diabetes
Regional Quality Strategy
Improving Safe Use of Blood Thinners
QUEST: High Performance Hospitals
Bethesda North and Good Samaritan hospitals, as part of TriHealth, joined this three-year, national program in December 2007. Premier Health Care Alliance runs the program and collects data from more than 150 hospitals across the country. Hospitals must meet or exceed evidence-based national standards to score in Premier's top quartile for performance.
Its goals are improving a person's inpatient experience by maximizing:
- quality
- safety
- patient satisfaction
- cost effectiveness
First-year Premier goals:
Treat, educate and document care for patients according to set criteria for:
- acute myocardial infarction
- heart failure
- pneumonia
The hospital must complete all measures for each patient for the diagnosis to receive a "perfect care" score.
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Maximize efficiency
Look at all costs associated with each episode of acute care and make the most effective use of staff and supplies to eliminate unnecessary expenses. At the start of the study, TriHealth's baseline performance in this area was superior.
Implement improved processes to reduce unpredicted mortality.
Second-year Premier goal:
- Identify measures for harm avoidance and patient satisfaction.
Premier's SafetySurveillor will be implemented at TriHealth by fall 2008 to track information on hospital-acquired infections. The new system will alert the hospital about potential infection control problems on a unit. It also will allow optimal antibiotic use.
By participating in QUEST, we are striving to achieve the highest possible performance in the following five areas, with the goal of reaching top quartile performance set by Premier in each:
- percentage of patients receiving perfect care using nationally recognized, evidence-based measures
- efficiency
- eliminating avoidable deaths
- patient experience
- harm avoidance.
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Aligning Forces for Quality--Managing Diabetes
Cincinnati is one of 14 sites nationally participating in a communitywide collaborative called Aligning Forces for Quality. Led by the Health Improvement Collaborative of Greater Cincinnati, Aligning Forces seeks to help communities improve the quality of health care they provide for chronic diseases in ambulatory settings.
TriHealth and other health leaders are working to:
- standardize the way physician practices approach the disease
- engage patients in taking control of their health.
With a $600,000 grant from the Robert Wood Johnson Foundation, Aligning Forces has embarked on a three-year mission to align market players to support physicians as they help patients manage diabetes. Market forces include:
- hospitals
- physicians
- patients
- employers
- insurance companies
- government
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Regional Quality Strategy
Patient-centered care in hospitals is the focus of the Greater Cincinnati area's Regional Quality Strategy. In 2008, the Robert Wood Johnson Foundation has awarded the region a $1 million grant to execute the program.
The Regional Quality Strategy team includes:
- hospital CEOs
- chief nursing officers
- key staff responsible for quality, including nurses
- frontline staff from half of the hospitals in the region
- consumers
- publicly funded health care organizations
The team has pledged to produce an action plan within one year to improve coordination of patient-centered care and to introduce an educational collaborative in at least one hospital.
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Improving Safe Use of Blood Thinners
TriHealth is working with 46 hospitals and health systems across Ohio to reduce complications of using blood thinners (anticoagulants). Patients take anticoagulants to prevent blood clots following a stroke, heart attack or vascular surgery.
The project, coordinated through Ohio Patient Safety Institute and VHA Inc., is creating or upgrading safety protocols to appropriately start patients on anticoagulants in the hospital and monitor them after they've returned home.
TriHealth has a 20-member team, including nurses, doctors and pharmacy and laboratory personnel, to look at its medication processes:
- prescribing
- procuring
- transcribing
- dispensing
- administering
- monitoring
The goal is to make all steps consistent and automatic, with cross checks whenever possible.
The team is focusing on Heparin, Coumadin and Lovenox. It has standardized how it documents doses for all three and has begun keeping only one concentration of Heparin, though three are available. The system may eventually expand to other medications.
The Joint Commission accrediting body requires accredited hospitals to have standardized practices on the medications in place by Jan. 1, 2009.
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