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All of us in health care are living through a time of enormous change. Advances in medical practice, combined with dramatic breakthroughs in technology and pharmaceuticals, have changed the ways that we minister to our patients and residents. Likewise, constraints in our resources due to reduced reimbursements, a faltering economy and the uncertainty regarding the short- and long-term affects that health care reform efforts will have on our ministry have fueled efforts to rethink and reexamine ways that we can provide the best possible care in the most efficient and effective manner. Many of our system-wide efforts…in particular, the ACT (Advancing Clinical Transformation) Initiative… require changes to the way we provide care. Since its inception in early 2009, the ACT Initiative has made significant strides toward its key objective: to identify, analyze and implement clinical transformation opportunities that result in superb clinical outcomes and enhance quality and patient safety across the system, which result in excellent operating and financial performance. ACT targets have been set and task forces are working to eliminate pressure ulcers, ventilator associated pneumonia, catheter associated sepsis, falls with injury, and sepsis from urinary tract catheters. Targets have also been set to reduce length of stay, avoidable readmissions, and payment denials. Progress on these clinical initiatives has been encouraging…and widespread. For example, ventilator associated pneumonia (VAP) rates at Saint Joseph’s Hospital of Atlanta have fallen dramatically with bundle implementation and other actions. In 10 recent months, no VAPs were observed. Similar successes have been realized at many of our RHCs. Through our Advancing Clinical Transformation (ACT) initiative, we are well on our way to achieving Vision 2017 via the first phase of Comprehensive Care Management. The work that we have collectively completed in the first three months of hospital case management transformation including the MIDAS+ implementation represents the engagement of many of our clinical colleagues, especially the hospital case management directors. Earlier this year, all but two of our acute care hospitals ‘went live’ with a new and transformed model for hospital case management which included the implementation of the MIDAS+ software. MIDAS+ provides a powerful view of hospital clinical performance, including valuable, objective information that shows the CHE hospitals in comparison with over 500 hospitals in the MIDAS+ database. With this tool, we can now look at our LOS performance with data that is severity-adjusted using the APR-DRG methodology. As part of ACT, we are also establishing a system-wide Medication Management function that through our physicians, pharmacists and other health care professionals, will enhance our process for medication management that is safe, medically appropriate and cost-effective and that best serves the health interests of our patients. Medication management will include formulary development, utilization, standardized order sets, implementation of CPOE (computerized physician order entry) and other relevant topics as identified. Initially, we plan to focus on a formulary system. The American Society of Health System Pharmacists (ASHP) believes that health systems should develop, organize and administer a formulary system that follows established recognized principles in order to optimize patient care by ensuring access to clinically appropriate, safe and cost-effective medications. ASHP defines a formulary system as an ongoing process through which a health care organization establishes policies on the use of drugs, therapies and other drug-related products and identifies those that are most medically appropriate and cost-effective to best serve the health interests of a given patient population. Pharmacy directors, Pharmacy and Therapeutic Committee members, patient care executives and chief medical officers kicked off this important initiative in October. These encouraging efforts and results are thanks to the dedication, persistence, and hard work of a great many colleagues throughout all of our RHCs and the Catholic Health East System Office. Our ACT teams will continue to work on developing and implementing breakthrough processes that reduce and eliminate the incidence of hospital-acquired conditions, reduce length of stay, and reduce readmissions within 30 days of discharge. In many ways, this first full year of investing such a great deal of time and energy into our ACT Initiative was a “leap of faith.” We had the courage to focus on clinical improvement and outcome…and we are starting to see results in many clinical areas…and we have the faith that financial rewards will follow as a result of the clinical transformations that are occurring. We are indeed starting to realize significant savings; I’ll share more details in a future issue of the CEO Report. This is an enormous, multi-year initiative that promises major improvements and enhancements for our ministry – include significant quality and safety improvements as well as enhancements to physician and clinician workflow – but it is very hard work and requires significant resource commitments unparalleled in the history of CHE. The achievement of these breakthrough changes, which will help us meet the changing needs of our patients and residents, are key to our ministry’s ability to survive and thrive in the future. Your support will enable us to meet our Mission of continue to be a transforming, healing presence in the communities we serve…for many years to come. Sincerely yours,
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