In November, all seven Hartford (Conn.) HealthCare hospitals received "A" safety grades from The Leapfrog Group for the second time. Since 2019, the health system has reduced hospital-acquired infections by 40% and serious safety events by 39%.
This success can be attributed in part to Hartford HealthCare's transition to a regional governance model that prioritizes quality, safety, credentialing and community health, CEO Jeffrey Flaks told Becker's.
"This enhanced a level of focus and attentiveness at the governance level to strengthen the accountability within our leadership teams," he said.
A culture of continuous improvement also plays a crucial role.
"It's hardwired. The mantra within Hartford HealthCare is being the best at getting better, and that's a core part of our culture," he said. "What that translates to is continuous improvement and a constant attentiveness to assessing our performance. How do we constantly learn? How do we constantly grow? And how do we challenge ourselves to improve?"
The How Hartford HealthCare Works operating model supports this culture, with daily department huddles and visibility dashboards tracking quality and safety metrics down to the individual patient level.
Investments in leadership, infection prevention
Hartford HealthCare has bolstered its leadership structure and invested in professionals dedicated to quality and safety initiatives. Leaders and other staff members collaborate with infection prevention teams to implement best practices, such as "device timeouts" to assess whether patients need central lines or Foley catheters, reducing unnecessary device use and associated infections, Chief Quality Officer Stephanie Calcasola, MSN, RN, told Becker's.
In the last four years, Hartford HealthCare repledged its patient safety commitment, retraining staff on high-reliability practices.
"We embed best practices to ensure the system is designed to produce what it's supposed to as much as possible, and it reduces the potential for human error," Ms. Calcasola said.
An example of a high-reliability practice includes adherence to checklists for complex procedures or activities requiring standard protocols, she added.
Scaling successes
Hartford HealthCare draws inspiration from other organizations as another tactic.
"We study the bright spots and then scale that across the system," Ms. Calcasola said. "Whether we're talking about hospital-acquired infections or another improvement, we embed the experts who are leading achievements to be teachers and mentors across the system."
The system achieves consistency throughout all seven hospitals through forums where best practices are agreed upon and implemented. Continuously monitoring and studying the results is also key, Chief Clinical Officer Ajay Kumar, MD, told Becker's.
"Our focus on improving safety culture across the system is almost unrelenting," Dr. Kumar said. "Our role as a system from a high reliability and culture perspective is to not find faults in the people, but to find faults with the systems."
Setting bold goals
Mr. Flaks emphasized the importance of structuring the board and governance to serve as quality and safety fiduciaries, as well as adopting "radical transparency," which he said is critical for making improvements.
"It's important to set bold ambitions around quality and safety initiatives," he said. "We have continuously challenged ourselves with very bold ambitions around tremendously reducing serious safety events and working to eliminate hospital-acquired infections. By setting these goals, we build them into our balanced scorecard. This allows us to monitor them, to be accountable to them, and to incentivize the entire organization around these quality and safety initiatives."