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On April 10, 2012
Indiana Hospital Association launched a hospital engagement network, Coalition for Care
through the American Hospital Association’s Health Research & Educational Trust
supported by the Centers for Medicare & Medicaid Services’ Partnership for Patients initiative.
IHA and its participating member hospitals are joined by 33 other state hospital association partners
and more than 1,600 hospitals throughout the country
working to reduce patient harm by 40 percent and readmissions by 20 percent by the end of 2013.
No easy task, IHA’s 119 hospital engagement network participants
have been working diligently to achieve the
Partnership for Patient Safety goals
while improving overall patient safety and quality of care.
Indianapolis-based Franciscan St. Francis Health
is a Coalition for Care member
focusing on all 10 Partnership for Patient target areas for improvement.
This Accountable Care Organization has actually tied the Partnership for Patients goals
into its own Journey to Excellence
and has seen measurable improvements
in patient and employee satisfaction, patient safety and the quality of patient care.
We have five Franciscan values. And those five Franciscan values are extremely important to us.
Respect for life. Compassionate concern. Joyful service.
Fidelity to our mission and stewardship.
And they're taken strictly from the life of Francis. That's our DNA.
In other words, as Francis lived his life, as Francis ministered to the sick, the poor and the indigent
so too, all of our employees know that we're one family.
And being one family, we hold one another accountable.
In 2008, we were looking at the organizational goals
and strategic plans and as we all know
strategic plans can become very lengthy.
Fifty pages plus, depending on how much you want to put in there.
So we decided that it was going to be a really nice thing if we could
engage our staff from the top, from the CEO, all the way down to our front line staff.
And be able to develop goals that we all knew what they were
and were all working in the same direction
and that program was the Journey to Excellence.
Driving performance as St. Francis has always been a partnership
between our board of directors, our senior leadership, our clinicians and our physicians.
We bring all of those people together in the quality counsel to help
establish goals, and to drive performance and help us set priorities.
Six years ago, 20 percent of our staff left every year.
Today, 10 percent of our staff leave every year.
Quince Scooter tells us that organizations that have an 88 percent retention rate or higher are safer hospitals.
This year, we were recognized as one of the safest hospitals in the country by Health Grade.
Our patient satisfaction is higher because when you're doing the right thing and you're taking
good care of the patients and your employees are happy, your patients will be happier.
I believe that the employees here at Franciscan St. Francis Health have a longevity
in their service because they're actually called to the ministry of the philosophy of the sisters of St. Francis.
The individuals who work here
come with a heart that is mission driven
and wants to follow the mission and values of our organization.
And I believe that they find that they are really being able to be involved in patient care
impact patient care and make a difference in people's lives.
One of the Journey to Excellence goals
set forth by hospital leadership
was to make sure that our infection rates are low
and that our patients are safe, they're protected
from getting infections while in the hospital.
I think that protecting our patients from infection in the hospital
matches the mission of the hospital, and what every nurse
wants to make sure they do when they walk into work every day.
They're here to protect their patients
and to take care of their patients the best that they can.
I believe we are constantly improving care
but that we have really reached an enhanced level of nursing practice
here at St. Francis.
We have challenged our nursing staff to acquire
a professional practice model.
That means that nurses are held accountable
for the quality of their care.
We've spent a lot of time using metrics
and using Lean Six Sigma techniques
in order to do performance improvement
We've spent a lot of time educating the staff about how we do performance improvement.
and how that's really aligned with our mission and values.
Pressure ulcers are one of those hospital acquired conditions
that has been directly linked to the amount in the quality of nursing care that is provided.
In 2008, moving into 2009, we really began ramping up our
internal processes for measuring and tracking and preventing
hospital acquired pressure ulcers to meet those CMS requirements
and to protect our patients from harm during their stay.
We always are looking for better ways to improve our rates.
We were down to .5 in incidence
and to Stephanie and I, that's still too high.
Even though the national average is 3.3, we want to get it down to zero.
No patient should have any kind of pressure ulcers while they're in our hospital.
Franciscan St. Francis Health
attributes reductions in hospital acquired conditions
and patient readmissions to the implementation of programs
and techniques focused on efficiency and quality.
We implement Lean Six Sigma throughout our organization.
We've applied it a lot recently in patient satisfaction.
We've seen some significant improvements in patient satisfaction
where as we have seen growth and improvement over the years
but with the application of some of the methodology
we're able to see larger improvements in areas
where we're able to reduce wait times
improve through put and meet our customers expectations.
We initiated what we would call the passport program
that ties right into our Journey of Excellence program.
And what we do with those
is the goals are, once they're decided upon
they're printed into a formal small document
and because this is a journey, we're looking at passports
that we're all traveling and making this journey
and this all goes to the frontline staff.
Every employee receives one of those.
And then, with their managers and their supervisors,
They work on, how can they be part of that.
I think one of the most important things we've implemented
is introducing Kisen.
Kisen is a Japanese word meaning 'change for the good or better.'
And part of our journey has been to get Kisen applied
in every level of the organization, engaging every employee
at small continuous changes throughout the work that they do.
We've made tremendous progress in the area of medication safety
which from a physician standpoint is obviously a huge issue.
And I think we're well down the road,
in terms of medication reconciliation
which basically means that we make sure at every step of the patients care
they're getting the right medications, the right doses
and they understand when they go home
what their medications are.
Our culture has always been to include our practitioners
and engage our patients in their care.
That is a key focus that we have in our population
readmissions within 30 days is sometimes common
if the patient is not appropriately contacted follow discharge.
So we are going into the home to educate them on their medications
and other things such as dietary and exercise regiments
that they need to utilize to keep their health better
and keep them out of the hospital.
Our journey has got to be,
I think the same as all hospitals' Journey to Excellence.
We need to do our part to reduce costs, while we're improving quality
and improving the health of our population.
We partnered with the Indiana Hospital Association
And they have partnered with and contracted with HRET
The Health Research and Education Trust
under the American Hospital Association
and we have been thrilled. We may have the largest engagement network in the country.
That is so much knowledge and so much information that we have at our fingertips
and access to any given time of the day
and the educational opportunities are just phenomenal.
Franciscan St. Francis Health’s Journey to Excellence is far from over,
but the organization has shown us that through hard work,
dedication and input from all levels that anything is possible
and that reducing inpatient harm by 40 percent and readmissions
by 20 percent in all 10 targeted areas by the end of 2013
are achievable goals.