HANYS Presents Pinnacle Award for Quality and Patient Safety
HANYS presented its 2017 Pinnacle Award for Quality and Patient Safety to providers in four categories:
- system or hospital with more than 500 beds,
- hospital with 200 to 500 beds,
- hospital with less than 200 beds, and
- post-acute/outpatient provider.
NYU Langone Medical Center received HANYS’ Pinnacle Award for Quality and Patient Safety for the category of a system or hospital with more than 500 beds for its Discharge Before Noon (DBN) Challenge program, a comprehensive, sustainable, and portable team-wide intervention to dramatically improve patient flow in the hospital. The goal was to increase the percentage of patients who are ready to be discharged safely before noon from 7% to 30%.
The DBN Challenge was launched in March 2012 by partnering with key stakeholders and fully leveraging the power of an interdisciplinary team. Successful results include:
- the DBN rate increased from 7% to more than 40% and has been sustained for four years;
- the initiative has been implemented across the institution and has been replicated at a newly acquired hospital;
- the observed-to-expected length of stay has remained consistently low;
- the readmission rate has held steady at 15%; and
- patient satisfaction scores for care coordination increased by 19 points.
St. Catherine of Siena Medical Center, Smithtown, won the Pinnacle Award for Quality and Patient Safety in the hospital with 200 to 500 beds category for improving patient outcomes through collaboration with emergency medical services to enhance quality of pre-hospital communication. The organization’s goal was to work collaboratively with emergency medical services (EMS) providers to enhance their communication with emergency department (ED) staff, to trigger a situational awareness that a stroke patient would soon be received. A Plan-Do-Study-Act quality improvement methodology was used together with Six Sigma principle. The “trigger” of the EMS communication of critical patient data expedites determination of the patient’s candidacy for tPA administration and facilitates timely and appropriate care.
Successful results include:
- all ischemic stroke patients received IV tPA within 60 minutes of arrival (2016);
- fifty percent of ischemic stroke patients received IV tPA within 45 minutes of arrival (2016);
- the door-to-ED physician assessment time improved 13.5% (2016 vs. 2014), with 89% of stroke patients assessed by the ED physician within 15 minutes of arrival (2016); and
- there was a 74% increase in obtaining quality pre-hospital communication from EMS during transport of a potential stroke patient (2016 vs. 2014).
St. Joseph Hospital, Bethpage, won the Pinnacle Award for Quality and Patient Safety in the hospital with less than 200 beds category for its Reducing Rule-Based Error: Implementation of PDSA and its Impact on Alarm Fatigue initiative. Recognizing a problem with over-generated clinical alarms, in December 2015, an interdisciplinary team consisting of nursing administration, nursing education, cardiology, biomedical engineering, monitor technicians, and frontline nursing staff gathered together to formulate a solution using the Plan-Do-Study-Act model for process improvement. Implementation of the initiative resulted in improvements in alarm generation and quietness of environment, without jeopardizing patient care, measured by the number of transfers to a high level of care. Successful results include:
- non-critical clinical alarms per patient day decreased by 39%. If no changes were made, an additional 820,000 non-critical clinical alarms (visual and audio) would have been generated from July through December 2016;
- transfers to a higher level of care decreased 9.6% post-initiative; and
- there was a 26% improvement in the patient experience of care “Quietness of Room at Night” question, compared to the six months prior to implementation.
Bassett Medical Center, Cooperstown, received the Pinnacle Award for Quality and Patient Safety in the category of post-acute/outpatient provider for its Achieving Electronic Clinical Quality Measure Success in an Integrated Healthcare System through a Team-Based Approach initiative. Bassett Medical Center’s project facilitates quality reporting while increasing access to the real-time information needed to attain and maintain continuous quality improvement. A Performance Improvement Quality Metrics Workgroup, Data Analytics Team, and Performance Improvement Executive Council were established to successfully manage and improve performance regarding quality indicators, patient outcomes, and the patient experience.
Through a comprehensive analysis of 76 clinical quality measures, the team prioritized the clinical quality measures on which to focus initially: hypertension and diabetes. The initial measures for improvement were hypertension and diabetes. The initiative resulted in a positive impact in disease management. Successful results include:
- hypertension control increased 11% (from 69.9% in 2015 to 77.6% in 2016);
- hypertension control in diabetic patients increased 10%: (2015 YTD 72.9%; 2016 YTD 80.4%);
- depression screening increased 98% (39.2% in 2015 to 77.5% in 2016); and
- nephropathy screening in diabetic patients increased 7%: (81.0% in 2015 to 86.7% in 2016).