How 3 organizations have used patient safety to improve financial results

"Better quality care is less expensive," George Mayzell, MD, told a crowd at the Becker's Hospital Review 6th Annual Meeting May 8 in Chicago.

Dr. Mayzell participated in a panel discussion on how provider organizations are using quality and patient safety initiatives to improve financial results.

In addition to Dr. Mayzell, who is the senior vice president, CMO and chief integration officer of Chicago-based AMITA Health, panelists included Beverly Bokovitz, RN, CNO of St. Anthony's Medical Center in St. Louis; Scott Ellner, DO, president of Saint Francis Medical Group and director of surgical quality at Saint Francis Hospital and Medical Center in Hartford, Conn.; and William Munley, vice president of orthopedics, general surgery and professional services at Greenville, S.C.-based Bon Secours St. Francis Health System.

The panel was moderated by McGuireWoods Associate Meggan Michelle Bushee.

According to Mr. Munley, the connection between patient safety improvement initiatives and hospital finances has changed. "Up to a few years ago, quality was really just kind of a nicety; everybody was saying 'We're high-quality' but there really weren't many financial implications associated with those claims," said Mr. Munley. But now, with penalties tied to infection rates and reimbursement relying on patient satisfaction, having high quality has a direct connection to a hospital's bottom line.

Quality and patient safety as related to a hospital's bottom line can be categorized into three "buckets," according to Mr. Munley. The first includes the reimbursements and penalties associated with the federal value-based purchasing program.

The second implication addresses the individual costs per patient case added to hospital service lines that result from poor quality and complications, such as infections, wounds, accidental punctures and lacerations, mortality rates and readmissions.

The third implication is related to a hospital's opportunity to land managed care contracts based on a provider organization's value equation, which can be maximized by improving quality and reducing costs.

Each panelist's organization has implemented innovated strategies and programs to address quality and patient safety as well as costs.

For instance, St. Anthony's Medical Center has tackled hand hygiene compliance, Ms. Bokovitz explained. So the organization took the multimodal approach presented by the World Health Organization and the eight-step process for leading change from John Kotter. Since implementing the program, hand hygiene rates have improved to about 95 percent, with physicians at 100 percent. Additionally, "we've kept patients from getting infections," she said. The increase in hand hygiene compliance has been linked to a decrease in surgical site infections and other HAIs as well.

At Saint Francis Hospital and Medical Center, Dr. Ellner has approached a different quality issue. "Our journey in the organization goes back to a single event," he said. He explained that one night in the OR, a patient suffered from a routine foreign body. The patient had to undergo four more operations and eventually died. "It was a burning platform to look at the culture and how we could do much better," he said. The hospital implemented surgical checklists and worked on getting buy in from physicians, frontline employees and executives through a communication program. In four years, the hospital has seen the complication rate drop from 21 percent to 6.85 percent — in other words, that means 500 fewer complications, 150 patient lives saved and a savings of $7.5 million. They have also received support funding from malpractice carriers in the area to spread the system to more acute-care hospitals in the state.

AMITA Health started working on the Race to Value program about a year and a half ago, according to Dr. Mayzell. The program is centered around driving out variation in medical practice by collaborating with physicians around key diagnoses. The program has lowered length of stay and cost per case, as well as readmissions. However, Dr. Mayzell emphasized this is not a one-off project. "It's a great collaborative ongoing project," he said. "This project doesn't really end."

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