Straight Talk - "The NCH path toward greater quality"

October 3, 2013

Dear Friends and Colleagues,

All of us should be proud of the reputation that NCH has earned as a quality healthcare institution.  To get better, we must constantly learn.  And when it comes to continuing education, we clearly believe in “sharing the wealth.”  That was very much on display this past weekend and over recent months, as these three examples show.

  • Karen Judd, Director of Rehab Therapy Operations emailed about her NCH downtown seminar that I was privileged to address:

Dr. Weiss, Thank you for taking time out of the Mayo conference to stop in to speak to the 27 physical therapists taking the first of a two-day Continuing Educational Unit course put on by our own staff.   Our career ladder was a big reason that two of our therapists prepared and presented this seminar.   In the cost containment atmosphere, putting on our own courses is a huge benefit to the therapists and a savings to NCH.  Teresa Carideo, PT, and Andrei Altavas, PT, gave countless hours of their own time in developing this course entitled, “An Integrated Approach to Physical Therapy Management of Headaches, Neck and Facial Pain.”  We will have another course on shoulders that will be presented by three of our colleague clinicians on Nov 2.  In addition, we celebrated our therapy staff in September during rehab week with the entire therapy staff from both hospitals, acute care staff, Brookdale Center therapists and all six of our outpatient therapy clinics.  More than 80 staff attended across the system.

  • I also attended the course in which more than 70 NCH physicians, nurse practitioners, and physician’s assistants volunteered for a four-hour seminar taught by four of our Mayo colleagues who are both practicing clinicians and teachers in Mayo’s Program in Professionalism and Ethics.  This “Communication in Healthcare” seminar refreshed, developed, and helped us practice superior communication skills ranging from information gathering, relationship building, and educating patients.

Therapeutic relationships are formed best by partnering, understanding, respecting, and supporting.  A meaningful patient relationship starts with active listening, letting the patient speak uninterrupted and asking a patient, “What else is a concern?”  Mutually agreeing on an agenda makes for time well spent.  Concluding by asking a patient to share his or her understanding of the diagnosis, treatment, and prognosis fulfills the caregiver/patient commitment.  Simplifying, clarifying, and verifying clinical information is key to an overall better experience.

  • In another email, RN Jon Kling, Microsystem Director of Intensive Care and Emergency Room, congratulated NCH physicians, nurses, and support folks for achieving a 15.75% mortality rate for sepsis and severe sepsis patients.

This terrific result must be viewed against the initial goal for top 100 hospital numbers of 22%, and our baseline for severe sepsis, 32.75%.  Moreover, in July, we experienced an all-time low mortality rate of 8%; an all-time high of 75% utilization of recommended Power Plan care sets (evidenced based physician orders) from the alert; and a reduction in mortality percentage of 47%.  On a year-over-year basis, we have saved about 233 patients from death by sepsis, almost 50% of this patient population compared to the previous year.  Dr. Doug Harrington, a critical care physician and leader in the project shared his congratulations with a well informed comment, “The success is attributed to a team of emergency physicians, hospitalists, intensivists, Nurse Practitioners and RNs.”  Remarkable job by all members of the team!

These are all great examples of continuing education and execution.  The national healthcare reform journey may be an uncertain one, but the NCH path toward greater quality proceeds uninterrupted.  Thank you all.


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

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