Strong leadership, a culture that fosters continuous improvements in care and innovations that hold the promise of transforming clinical training and enhancing patient safety have earned Memorial Medical Center in Springfield, Ill., the 2016 AHA-McKesson Quest for Quality Prize.
The AHA July 17 presented the award to Memorial at the Health Forum and AHA Leadership Summit in San Diego. Also recognized were prize finalist Memorial Hermann Greater Heights Hospital in Houston and citation of merit recipient Our Lady of the Lake Hospital in Baton Rouge.
The prize honors hospitals that are making impressive strides towards the Institute of Medicine’s six quality aims of safe, effective, efficient, timely, patient-centered and equitable health care.
Memorial’s performance-improvement culture. As part of its effort to boost performance, Memorial in 2010 adopted the Lean Six Sigma methodology. It’s helped the medical center increase quality and eliminate inefficient practices – and led to a higher-performing care system, says Charles “Chuck” Callahan, Memorial’s executive vice president and chief operating officer.
“We’ve reconfigured our whole quality structure from the board down to front-line personnel,” says Callahan, who also heads Memorial’s quality safety performance committee of community physician and administrative leaders. The committee identifies quality-improvement priorities and reports directly to Memorial’s board.
Callahan credits Lean Six Sigma with enabling Memorial to achieve $30 million in savings while advancing quality care and patient safety.
“Every year we want to train 30% more people across the organization [through Lean Six Sigma projects], complete 30% more projects and be 30% more efficient in each project than the previous year,” says Todd Roberts, the medical center’s quality and safety administrator.
The results are impressive. From 2013 to 2015, the hospital saw a 23% reduction in stroke mortality, a 68% reduction in stroke-related complications and a 92% reduction in hip fracture readmissions. The hospital also reported a 70% reduction in colon surgical site infections from October 2013 through February 2015.
Callahan says Memorial knew it was making serious progress when the Illinois Hospital Association recognized the hospital for a Lean Six Sigma project that reduced red blood cell transfusions by 32% and achieved $2.8 million in savings in 2014. That came a year after Memorial Health System, the medical center’s parent organization, received the state association’s top quality award for reducing hospital-acquired pressure ulcers by 81% over a 32-month period.
“Those were hallmark projects for us,” Callahan says. The awards “validated our quality and safety programs … that we were working on the right things and achieving results.”
Innovation. Another major step forward was the medical center’s partnership in 2014 with the Southern Illinois University School of Medicine to form the Midwest Healthcare Quality Alliance. The Springfield Clinic, an independent medical group with more than 400 physicians and advanced practitioners in nearly 90 medical specialties, joined the alliance earlier this year. The alliance is designed to develop innovative solutions for improving health care access, quality, safety and community outcomes.
Shortly after its formation, the alliance launched an Agency for Healthcare Research & Quality-certified patient safety organization (PSO). The PSO tracks what medical errors occur and determines why they occur; and how to prevent their reoccurrence by collecting information, analyzing errors and sharing lessons and preventive strategies with others. Information shared through the PSO remains confidential and is legally protected.
Memorial’s PSO includes hospitals, ambulance services, post-acute care (PAC) facilities and physicians’ offices. The PSO offers an opportunity to improve the system and prevent harm, rather than playing the “blame game” for medical mistakes, Callahan says.
The medical center is a Level 1 trauma center with 70,000 emergency department (ED) visits a year, he notes. A lot of emergency care is provided on the way to the hospital, and Callahan says the PSO “brings ambulance drivers into the health care fold as part of our team.” And he says it helps to bolster patient safety across the care continuum. “When a hospital is on the hook for a 30-day readmission, heck, 28 of those days may occur in a nursing home,” he observes. “The PSO is a way to improve care because it is a safe umbrella that encourages the sharing of information and practices” between the hospital and PAC providers.
The Quest for Quality prize committee noted Memorial’s 72,000-square-foot Memorial Center for Learning and Innovation, a technologically advanced learning environment where Memorial staff, medical residents, physicians and community health partners can hone their clinical skills. Memorial opened the center last year.
It includes a 16,000-square-foot simulation center on the third floor. The simulation area features 10 separated simulated environments, including a nurse’s station, patient room, operating room, an office and an exam room.
An intensive care unit (ICU) serves a dual purpose as a labor and delivery room. Two rooms – a trauma bay and a treatment room – simulate an ED setting. The simulation center also has a mock residence with a kitchen, living room, bedroom and bathroom in 1,300 square feet. The area has half walls for easy observation, and can be used for training by ambulance providers, firefighters and home service and hospice caregivers.
A high-tech ambulance simulator, which mimics on-the-road movement, allows emergency medical technicians to train as if they’re transporting patients to the hospital.
“The center replicates to an inch what we have in the hospital,” Callahan says. He says it is revolutionizing the training progress for ED residents by “promoting more active learning and retention.”
In December, the hospital and its partners conducted a complex simulation exercise at the center that followed a critically ill patient from the moment he called for help in his home until he was wheeled into an ICU. In the operating room, he was swapped out with a mannequin designed for surgical procedures.
The exercise focused on the care of this fake patient with a ruptured abdominal aneurysm. It studied the way a patient with a hypothetical condition was treated as the patient was handed off between a range of settings – all available at the learning and innovation center.
“This become a great research model for all types of conditions,” quality and safety administrator Roberts says. “This is part of the national focus on the continuum of care.”
Patient-centered care. What Memorial calls “the voice of the customer” is reflected in programs like its Joint Works Patient and Family Advisory Panel. The volunteer group of patients and family members meet with hospital staff to discuss what it was like to go through a total joint replacement surgery. Their insight and experience helps shape the services provided before surgery, during the hospital stay and after discharge from the hospital.
Memorial plans to extend the patient and family advisory panels for all patient services provided in the hospital and affiliated physician offices.
“We believe the voice of the customer is the perception of your quality, and that is something we want ingrained into our culture,” Callahan says.
Since 2002, the AHA has presented the Quest for Quality Prize to hospital quality leaders. But the prize is taking a one-year hiatus so the AHA can review and refresh the application and prize criteria to ensure they reflect emerging priorities and practices essential to advancing the delivery of high-quality, patient-centered health care. Hear Callahan describe how winning the award will spur Memorial to do better. And watch an AHA video on the Quest for Quality prize recipients.