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Judith M. Persichilli
President and CEO |
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June 2010
It has been over one year since our RHCs committed themselves to the goals and strategies of the ACT (Advancing Clinical Transformation) initiative. A sweeping, system-wide effort to implement breakthrough processes, the ACT initiative includes several key objectives, including reductions in the incidence of hospital-acquired conditions, length of stay, readmissions under 31 days, and administrative/clinical denials, as well as exploring new cost-saving and efficiency opportunities throughout our ministry.
Thanks to the ingenuity, persistence, and hard work of so many of you, a tremendous amount of progress was made in 2009. 16 RHCs reduced length of stay, and 13 RHCs improved upon administrative denials. Collectively, our institutions accounted for $76.3 million in cost savings in key areas such as clinical transformation, operations improvement, and system-wide opportunities. These are major achievements that have had a positive impact on our patients and our organizations.
I am also enormously proud of the important strides made throughout Catholic Health East in the reduction and elimination of incidences of hospital-acquired conditions, or HACs. Last year, our patient care executives came together to help select goals, set and review strategies, and share best practices with each other. The decision was made to focus system-wide attention on the following five HACS: catheter-associated urinary tract infections, central line-associated bloodstream infections, falls with injuries, hospital-acquired pressure ulcers, and ventilator-associated pneumonia.
The results were impressive. By the end of 2009, 13 RHCs reduced the incidence of pressure ulcers; 12 RHCs reduced incidence of catheter-associated urinary-tract infection; 10 RHCs reduced ventilator-associated pneumonia incidence; 10 RHCs reduced falls-with-injury rate; and 6 RHCs reduced the rate of central line infections.
But our ministry leaders were not ready to rest on their laurels. Encouraged by their clinical transformation successes, they set even more aggressive targets for 2010. For three of the clinical indicators (central line infections, falls, and ventilator-associated pneumonia), the goal for each RHC was set at ZERO. And I’m very proud to be able to report that, through the first quarter of 2010, ten RHCs have experienced no ventilator-associated pneumonia, nine have recorded no falls with injuries, six have had no cases of pressure ulcers, and three have yet to experience even one central line infection or urinary tract infection.
Establishing a goal of “zero tolerance” was not without its controversy. A few questioned the advisability of setting unrealistic goals, preferring instead to continue setting “reachable” goals and striving for incremental improvement. As the patient care executives discussed this matter last year, there arose consensus among the group that CHE needed to make a statement by embracing the target of zero tolerance for hospital-acquired infections. It was a goal whose time had come. It was noted that striving for excellence had helped to virtually eradicate other public health problems of the past, such as polio and tuberculosis. As Julie Gerberding, director of the Centers for Disease Control noted in 2000, total elimination of these two diseases may not have occurred, but “…ambitious goals drove positive change and dramatic reductions.”
Many professional groups, including the Association for Professionals in Infection Control and Epidemiology (APIC), strongly support this “zero tolerance “philosophy. According to APIC, as the number of antibiotics used to effectively treat infections has fallen, it became imperative for health care professionals to gravitate from a culture of treatment to a culture of prevention. As APIC noted in 2008:
“Targeting zero encourages all organizations to set the goal of elimination rather than remaining comfortable when local or national averages or benchmarks are met. Every single healthcare-acquired infection impacts the life of a patient and family – even one should feel like too many.”
This philosophy is totally in synch with our focus on person-centered care. Each person is the center of our work. With a culture of targeting zero for error comes the reminder…the inspiration… that every action, every treatment, every patient encounter truly does make a difference.
It is one thing to set goals; it is quite another matter to achieve them. By coming together as a system, focusing on pooling our expertise and experience with each other, and sharing best practices and “lessons learned”, we have made great strides in reducing the number of HACs across our ministry. Special congratulations to the staffs of Mercy Hospital of Philadelphia and Marian Community Hospital; both hospitals experienced zero incidences in four HAC categories during the first quarter of 2010. And kudos to the staffs of St. James Mercy, St. Mary’s Health Care System in Athens, Mercy Hospital in Portland, and Mercy Miami, who all experienced zero incidents in three HAC categories during the same time period. Hats off to the staffs of Mercy Fitzgerald Hospital, St. Francis Trenton and St. Francis Wilmington, who experienced zero rates in two HACs, and to the staffs of Saint Michael’s, Lourdes Medical Center of Burlington County, Mercy Suburban, Nazareth, and Sisters of Providence Health System, who experienced zero incidents in one HAC.
This is Catholic Health East at its best. We have learned over the past year that, together, we CAN make a difference. Together, we can learn from each other and make amazing progress in improving quality and patient safety system-wide. By lifting all eyes in our organization to the same worthwhile goal – improving every aspect of the patient experience – we will be truly person-centered.
Together, we are so much more.
Sincerely yours,
Judith M. Persichilli
President and Chief Executive Officer,
Catholic Health East
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