Two-year
quality improvement project yields
excellent, measurable results
King's
Daughters Medical Center embarked
on a journey two years ago to
create an innovative way to improve
quality for the hospital's heart
patients. After two years of persistent
work by doctors and nurses, the
plan produced impressive results.
Nationwide,
one in four congestive heart failure
patients return to the hospital
for another admission after being
discharged within 30 days due
to the nature of this chronic
illness. Congestive heart failure
is the #1 reason why people are
hospitalized, and the national
average for readmission of these
patients within 30 days after
discharge is 24%.
KDMC was already below average
when starting their program at
23.8%, but Dr Ross and the nursing
staff lead by Chief Nurse Executive
Cheri Walker wanted to improve
this number for KDMC patients.
Dr.
Jeffrey Ross, Director of Inpatient
Services said King's Daughters
Medical Center explains, "We
wanted to do more to help our
congestive heart failure patients.
A long collaborative effort was
launched involving many disciplines."
Results
of this innovative new strategy
took the congestive
heart
failure readmission rate from
23%
down to an impressive 13%
The
plan included working with many
patients, nursing staff and medical
staff members to address the problem
from several points of attack.
The staff began instructing and
reinforcing to patients after
discharge a number of factors
such as number and kind of medications
patient were on, and certain personal
choice habits like diet and weight
control. Key communications pieces
were implemented with the patient's
physicians, and the patient gets
a follow up call from a case manager
within a few days after discharge.
Home health agencies are also
involved to help monitor the patients,
and accurate scales for home use
were also provided.
The
results of this innovative new
strategy took the heart failure
readmission rate from 23% down
to an impressive 13%, which is
about one half of the national
average.
"The
hard work by many at KDMC that
developed the new strategy for
congestive heart failure patients
has made a significant difference
in quality for our patients,"
says Dr Ross, "with the dedication
of resources and man-power we
have shown real improvement in
this area is possible."
Early
in the quality improvement plan,
King's Daughters Medical Center
increased its financial commitment
by instituting a discharge nurse
to assist patients before leaving
the hospital. The discharge nurse
teaches the patients about their
disease and the importance of
taking medications as prescribed
by their physician. The discharge
nurse also helps with scheduling
of follow up appointments within
two weeks of discharge and answers
any questions patients may have.
"Innovation
is the hallmark of this quality
improvement project," explains
Dr Ross. In a first-of-its-kind
effort, KDMC initiated a home
visit program with nurse practitioner,
Tammy Lofton who actually visits
patients in their homes to see
if they are taking their medications,
understand lifestyle modifications,
and see their primary physician."
Another
innovative idea was initiated;
the hospital gave accurate digital
scales to patients who did not
have scales to monitor their weight.
KDMC provided approximately 100-150
scales to those patients that
needed them.
In
the future, King's Daughters Medical
Center will continue to improve
quality while new programs are
being implemented. Chart reviews
by designated nurses will guide
the refinement of the new strategies
for improving patient care.
"Since
this program has been so successful,"
says Dr Ross, "we foresee
the beginning of similar programs
for other illnesses such as pneumonia
and chronic lung disease."
"We
don't just say that we are a quality
hospital," says Dr Ross,
"our numbers on our quality
improvement projects prove it."
Dr.
Jeff Ross
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KDMC
AWARDS
HealthGrades
Outstanding Patient
Experience Award
2010/2011/2012
5 Stars - Specialty
Excellence Award
for Prostatectomy
2010/2011/2012
5 Stars - Recognition
of Stroke Survival
2011
HealthGrades
consider all 5,000
non-federal hospitals,
and are procedure-,
diagnosis-, and
service-line specific.
T-System
Awards
Client Excellence
Awards
Patient Service
- 2010
Performance Improvement
- 2010
Quorum
Health Resources
QHR Award for
Best Net Operating
Margin
- 2011
American
Baptist Health
Trust
5 Top Healing
Hospital
- 2009
AVATAR
Employee Opinion
Survey - Most
Improved
- 2012
CareChex
Quality Measures
CareChex incorporates
seven (7) peer-reviewed
methodologies
which specifically
address key components
of the quality
of inpatient care.
These include:
Core Process
Measures:
Patient Safety
Indicators
Inpatient Quality
Indicators
Mortality Rates
Complication Rates
Readmission Rates
Patient Satisfaction
Measures
Overall
Hospital Care,
Medical Care,
Surgical Care
#1
in MS
- 2010
Top 10% in MS
2011
KDMC Overall Medical
Care
Top 10% in MS-
2012
KDMC Patient Satisfaction
#1 in MS
- 2010
Top 10% in Nation
- 2010
#1 in MS
- 2011
Top 100 in Nation
- 2011
Top 10% in MS
and Nation -
2012
KDMC Patient Safety
Top 10% in Nation
-
2010
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