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Robert V. Stanek
President and CEO |
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March, 2008
As you all know, quality and patient safety are key areas of focus for Catholic Health East and our RHCs/JOAs. One of our Health Care 2017 Strategic Goals is for CHE to be ranked in the 10 percent of all nationally recognized and accepted quality and safety measures. Our strategies to achieve this goal include the implementation of evidenced-based processes and techniques to improve continually in quality and safety; and the implementation of clinical data systems to measure improvements in health care value and aid in the delivery of safe, quality care across the continuum.
I am pleased to report that, thanks to the dedication and hard work of so many CHE colleagues throughout the System, we continue to make great strides in our pursuit of our quality and safety goals.
In many ways, 2007 was the "Year of Quality" for CHE. Not only did quality rise to the top of both the CHE and local Boards of Directors' agendas in words—it also rose to the top in terms of actions and outcomes. I've summarized some of our major areas of quality improvement below:
- In 4 key dimensions of care (acute myocardial infarction, heart failure, pneumonia and surgical care) CHE performance soared to new heights as significant increased were achieved when comparing 3rd quarter 2005 through 2nd quarter 2006 (a rolling 4 quarter baseline) to 3rd quarter 2007 (our endpoint). In 3 of 4 of these targeted areas, CHE improved by more than 50%.
- CHE assesses its progress by using the half-life concept. Appreciating that the process of setting rational and motivating goals is extremely challenging, it may be the most important step of all in the improvement journey. If the bar is set too low, we run the risk of underachieving relative to our potential. If the goal is unachievable, we set our organizations up for disappointment and frustration. While "error free" or 100% compliance with these and other evidence-based practices is the ultimate goal in our pursuit of excellence, this is an absolute aspiration, and setting a target at this level may trivialize the process by establishing an unachievable objective, at least initially. An approach promoted by improvement experts and internationally renowned organizations such as the Institute for Healthcare Improvement (IHI), the "half-life" method in place by CHE focuses our efforts on goal setting in relative time. The desire is to bridge the gap between current care and desired, as defined by the top 10th percentile performance consistent with CHE's Vision for 2017. This bridge is defined in intervals of 50% improvement toward the desired outcome. Through this approach we can set both far-reaching goals and make meaningful targets for our staff, and most importantly, our patients. For CHE this meant as a System improving to the following levels of performance in 2007:
| Acute Myocardial Infarction (AMI) |
95.29 to 97.60% compliance |
| Heart Failure (HF) |
85.23 to 90.77% compliance |
| Pneumonia (PN) |
85.98 to 90.49% compliance |
| Surgical Care Improvement (SCIP) |
80.61 to 88.06% compliance |
- Three new portal learning communities this year aligned with the Institute for Healthcare Improvement's 5 Million Lives campaign specific to high risk medications, pressure ulcers and Methicillin-Resistant Staphylococcus Aureus (MRSA)/infections.
- CHE achieved 100% participation by all our Home Health agencies participating in the National Home Health Campaign to reduce unnecessary acute care hospitalizations. As an outgrowth of this participation, CHE agencies worked together to develop an acute care hospitalization tool kit emphasizing the importance of strategies such as front loading, telehealth, disease management, medication management, intake processes, and risk assessment in reducing the likelihood that patients would return unnecessarily to the hospital.
- CHE facilities also participated in the National Nursing Home Campaign, tracking our improvements associated with the Campaign's six aims around reducing pressure ulcers; eliminating the inappropriate use of restraints; enhancing pain assessment and management practices; enhancing resident satisfaction with services provided; and increasing efforts to ensure staff continuity.
- 2007 was the year in which we implemented clinical and satisfaction measures in other CHE continuing care ministries such as PACE, Long Term Acute Care Hospitals (LTACH), Assisted and Independent Living and Hospice consistent with our desire to continuously improve every aspect of person-centered care and service we provide.
- Targeted efforts occurred throughout the year as we worked together in the area of ED Patient Flow, conducting a nine-month long Collaborative on credible evidenced based change ideas associated with clinical, operational and service excellence, in what is often considered a "door" to our organizations. Recommendations are forthcoming from the work of 17 multi-disciplinary teams across CHE in terms of high impact interventions.
As evidenced by all of these accomplishments, Catholic Health East has made great progress in pursuit of providing the highest quality care and safest environments for our patients and residents. I am extremely proud of these achievements, and I urge you to continue your efforts in 2008 and beyond to help make CHE a transforming, healing presence in the communities we serve.
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