December 23, 2016
Marshall Medical Centers has earned an ‘Outstanding Performer’ award for safety from the Partnership for Patients, a national initiative led by the Centers for Medicare and Medicaid Services to reduce rates of hospital-acquired conditions and readmissions.
“It is this kind of commitment that is helping reduce patient harms while fundamentally changing how care is delivered,” wrote Dr. Keith Kosel, senior vice president of government affairs and project director for Vizient HEN. “These achievements are making a profound difference in the lives of the people who choose to use your hospital.”
The Partnership for Patients is focused on making hospital care safer, more reliable and less costly through the achievement of two goals:
* Preventing hospital-acquired conditions.
* Preventing complications during a transition from one care setting to another will reduce all hospital readmissions.
In order to apply these goals at Marshall Medical Centers a team concept is used to improve performance, along with efforts to engage patients and families in their care. Because patients are essential partners in the effort to improve the quality and safety of health care, their participation is an essential component of making care safer and reducing readmissions.
One particular area of emphasis as part of this partnership at MMC was a program designed to reduce readmissions for patients who undergo total hip or knee replacement. The implementation of "Joint Academy" helped to engage patients and their family or caregiver.
Joint Academy is a class that teaches patients what to expect before, during and after surgery. It explains how patients should prepare their home for safe return and best recovery. It allows opportunity for the team to discuss with patients their prescribed medications that are unsafe to take before surgery, how to prepare for surgery and warning signs to look for afterwards. The team leaders, a case manager and care coordinator, also make phone contact with patients to as their surgery date approaches, to ensure readiness for the procedure.
Following hip or knee replacement procedures, team leaders RN Robin Morgan Harper and Social Worker Amanda Lindsey make rounds with Orthopedic Surgeon Dr. Matthew Smith to visit patients and discuss questions that the patient may have, and to plan for care after discharge from the hospital.
Because educating patients is crucial to the healing process, Harper and Lindsey serve as ‘care navigators’ and teach patients about what they should be doing at home after being discharged from the hospital. Instructions are explained in a way patients can understand then patients are asked to repeat them to ensure their understanding.
The nurses and other team members also use white boards in patient rooms and keep them updated with goals for the day, the latest status on medications and pain levels. Whiteboards keep patients and family members updated with the latest information on the patient’s rehabilitation and level of independence.
Because falls are a common problem with joint replacements while a patient is in the hospital for the procedure and once they return home, the MMC nursing staff works to encourage patients’ mobility while helping prevent falls. In the hospital, patients are counseled not to try to get out of bed without a nurse or someone else with them. While many patients want to be independent and they don't want to bother a nurse to go to the bathroom, they are educated to understand the risk of falls and the best way to prevent them.
Infection Control Nurses Gloria Clemons and Casi Thompson tackled another initiative as part of this partnership. Their team received recognition for accomplishments in the national initiative of preventing hospital acquired conditions. The specific team goal is to reduce the occurrence hospital-acquired catheter-associated urinary tract infections. They work closely with the nursing staff and facilitate unit-based teams focused on identifying possible causes and prevention of infections.
The nurses begin each day with “morning huddles,” where they evaluate every urinary catheter to determine whether it should be removed. Clemons said most infections result from a catheter being left in too long.
“Basically we’re trying to remove the catheter as early as possible,” Clemons said. “The sooner we get it out the more likely we are to prevent a catheter-related infection.”
At the core of this nationwide Partnership for Patients initiative are 16 Hospital Improvement Innovation Networks (HIINs), which partner with more than 4,000 hospitals, working with healthcare providers and institutions, to identify best practices and solutions to reducing hospital acquired conditions and readmissions.
Vizient is the nation’s largest member-owned health care services company. Backed by network-powered insights in the critical areas of clinical, operational and supply chain performance, Vizient empowers members to deliver exceptional, cost-effective care at every turn.