Ballad Health | Tennessee/Virginia: Center for Clinical Transformation & Outcomes Optimization Encourages Shared Learning to Drive Improvement

About Ballad Health

Ballad Health is an integrated community health improvement organization serving 29 counties of the Appalachian Highlands in Northeast Tennessee, Southwest Virginia, Northwest North Carolina and Southeast Kentucky. Our system of 20 hospitals, post-acute care and behavioral health services, and a large multi-specialty group physician practice works closely with an active independent medical community and community stakeholders to improve the health and well-being of close to one million people. By leading in the adoption of value-based payments, addressing health-related social needs, funding clinical and health systems research and committing to long-term investments in strong children and families in our region, Ballad Health is striving to become a national model for rural health and healthcare.

The Center for Clinical Transformation & Outcomes Optimization

Ballad Health launched the Center for Clinical Transformation & Outcomes Optimization in 2022 as a new department to harness shared learning and drive improvements across the system.

Ballad Health was formed when two health care organizations merged. The Center for Clinical Transformation & Outcomes Optimization aims to break down silos and bring together key multidisciplinary stakeholders from both organizations, optimize processes and standardize care delivery across the system to improve the quality and safety of patient care.

The Center for Clinical Transformation & Outcomes Optimization established the following model to ensure system-wide engagement:

• System-level steering committees help improve patient safety outcomes in specific areas by reviewing data, identifying gaps in current practices and recommending potential solutions and evidence-based practices to improve the quality of patient care at all Ballad Health facilities.
• Implementation teams take recommendations from the steering committees and put them into practice across the organization’s 20 hospitals.
• Focus groups — made up of individuals from the steering committees — target key initiatives that are part of their broader projects.

One of the projects the Center for Clinical Transformation & Outcomes Optimization established was a virtual sepsis monitoring unit. Modeled after an air traffic control center, the virtual sepsis monitoring unit has nurses continually monitor patients for signs of sepsis and alert bedside caregivers when intervention is needed. This new unit contributed to a 27% reduction in sepsis mortality.

The Center for Clinical Transformation & Outcomes Optimization also focuses on pressure injuries, falls reduction, postoperative acute kidney injury, glycemic control and perioperative quality and safety.

Program Results

As a Center for Clinical Transformation & Outcomes Optimization, and in partnership with stakeholders such as nursing, infection prevention, risk management and quality leaders, Ballad Health has seen impressive improvements in patient outcomes and safety across several metrics:

• 50% reduction in hospital-acquired pressure injuries over a two-year period.
• 40% reduction in postoperative acute kidney injury over a one-year period.
• 15% reduction in falls per 1,000 inpatient days.

The Center for Clinical Transformation & Outcomes Optimization has become a catalyst for multidisciplinary collaboration and innovation throughout Ballad Health, encouraging providers and hospital leaders to crosspollinate their learnings. Whether being treated at one of Ballad Health’s larger tertiary facilities or at a small community hospital, Ballad Health strives to ensure that its patients will experience the same commitment to safe, high-quality care.