News at NCH
Straight Talk - "All in this together"

June 6, 2013

Dear Friends and Colleagues,

If NCH is to be a “destination hospital” and Florida is to be a “healthcare destination state,” then we must constantly work to improve the quality of the care we deliver.

In that spirit, avoiding harm and preventing complications were the front-and-center topics at last week’s Florida Hospital Association (FHA) Board meeting, where I had the honor to chair the Quality Committee, to share our state’s impressive progress. Although we have a ways to go on our journey toward superior quality, our state has progressed to the rank of 34, according to United Health Foundation (http://www.nchmd.org/state-rankings).


The goal of one leading national program, the Partnership for Patients Hospital Engagement Network (HEN), is to reduce readmissions 20% and preventable complications by 40%. Physicians, nurses, hospitals, employers, patients, payers, their advocates, along with the federal and State governments, have joined together to form the Partnership for Patients (http://www.nchmd.org/Partnership-for-Patients).

One of four mandates of the FHA Board Quality Committee is to increase participation in this HEN program among the approximately 310 hospitals in Florida, of which 219 are acute care hospitals. Right now, 107 Florida hospitals, including 13 who aren’t FHA members, participate in at least one HEN initiative. Only 26 Florida participate in all 10 initiatives, with improvements centered around avoiding medication errors, venous thromboembolism, pressure ulcers, falls, early elective deliveries, readmissions, surgical site infections, ventilator associated pneumonia, central line associated blood stream infections, and catheter associated urinary tract infections. FHA has 205 members including a few Psychiatric and Rehabilitation hospitals, and we’d like all of Florida’s hospitals to join in best practices and benchmarking to learn and compare, respectively.

On a more positive note, Florida’s hospitals decreased mortality nearly 36% from March 2011 to July 2012. An independent statistical study showed the improvement in clinical outcomes resulted in 89 lives being saved, 165 complications avoided, with 20 of 23 post-operative outcomes being improved. Surgical site infections are down nearly 16% over the same time period. These positive changes led to expense savings of $6.6 million. Florida is doing particularly well avoiding central line-associated blood stream infections and catheter associated urinary tract infections, with most other areas moving in the right direction.

Our second Quality Committee mandate was ensuring that hospital CEOs lead the initiative to higher quality and safety. Leadership also means emphasizing our third mandate, transparency and information sharing with all key constituents, importantly including patients. The age of Dr. Marcus Welby paternalism is long gone; we must share information and knowledge quickly and understandably. This leads to the fourth and final mandate of encouraging all of Florida’s hospitals to share data so that we all might improve together. One tried-and-true business maxim is that, “What gets measured, gets done.” In healthcare, we say, “If you are going to be naked, you’d better be buff.” (Literal translation: “The spotlight of transparency should make us all perform better.”)

Florida hospitals aren’t competing with each other; but rather are competing to serve our patients with better quality, harm avoidance, and complication prevention. We have much work to do but, we are talking, raising awareness, educating, sharing best practices, and providing feedback. These activities are all part of the virtuous cycle that is gaining momentum and will move Florida up the rankings for quality of life. In terms of producing better healthcare in the state of Florida, we really are “all in this together.”

Respectfully,


Allen S. Weiss, M.D., President and CEO

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