I want to use this column to relay some of the information that I, along with Dr. Michael Howell, University of Chicago Medicine’s Associate Chief Medical Officer, recently presented.
Our talk was entitled: High-Reliability Healthcare: Moving from Theory to Practice at UCM. It’s contained here in the entire deck from the forum, which also includes highlights of coming events, and some important safety/quality metrics and Press Ganey results.
Specific to reliability, we could have the best evidence-based clinical pathways, and very skilled staff focused on safety, but if we fail to execute our processes and procedures consistently then problems will occur. A lack of reliability, particularly in such a complex and complicated work environment as a hospital, could result in worse outcomes for our patients or a negative impact on the patient’s experience.
Once we’ve established or identified best practices through the application of evidence-based practice standards and we create our Standard Work, we need to follow them repeatedly. The only time we should deviate from them is at the request of a patient or their family – not because of arbitrary differences among healthcare professionals, or any other biases towards care.
If we’re consistent – reliable – then the outcomes for our patients, both clinical and their overall experience, will improve.
And we’ve had great results: 13 straight months of perfect scores in key quality measures for congestive heart failure and pneumonia, to name a couple.
Plus, I’m very proud of the leadership role our nursing teams have played in significantly reducing rates of CAUTI, the improvement in the inpatient overall rating of care, and gains in the prevention and treatment of sepsis.
Our approach to sepsis is a great example of the path to high reliability at UCM. Briefly, in July 2013 we had no standard approach to identifying and monitoring this terribly dangerous condition.
Starting in Fiscal 2014, we began a process to develop clinical standard protocols, backed by systems to validate what we were doing, and then ensure that these steps were followed.
As a result, we’ve had significantly better outcomes when dealing with and preventing this infection. In fact, we saved 50 lives in 2014 based on our work to detect sepsis early and treat it consistently. That is 50 more patients discharged to their families! That is significant.
I thank all of you for focusing on consistent execution of processes that are proven to improve the care and safety of our patients.
But the work is not done.
Soon, we are going to launch an institution-wide campaign around an area that is in need of improvement: hand hygiene.
There are about 75,000 opportunities for the consistent application of proper hand hygiene techniques around the medical center every day! But we are not yet meeting the goal of 75% compliance that UCM set for itself in the Fiscal 2015 Annual Operating Plan.
A pilot program in 8 South, for example, has produced some great results and highlights ways we can achieve our goal. Discussions about hand hygiene were built into existing workflows, progress is talked about during the twice daily huddles, and hand hygiene is included in Managing for Daily Improvement (MDI) boards.
I want to end by noting a particularly impressive story in this issue that underscores the professionalism and compassionate spirit of our nurses.
The University of Chicago Medicine’s Comer Children’s Hospital is the Chicago partner with the Fresh Start Caring for Kids Foundation, which arranges surgeries for kids with congenital deformities.
We had more than 30 nurses volunteer their time and expertise to improve the lives of children from all over. In late February, six children were involved in surgeries over a weekend, bringing the total number of kids who have participated in the three Fresh Start events to 19. Every section of nursing was involved.
Thank you to everyone who dedicated their weekend to helping these kids. It’s such a testament to our nursing staff, and I’m very proud to work alongside you every day.