Washington Hospital Better than State and National Benchmarks for Many Quality Measures
Today, more than ever, hospitals track and measure the things they do to care for patients as part of a nationwide movement to improve healthcare quality. Based on its commitment to providing the safest, most effective patient care, Washington Hospital is an active participant in this effort. It continuously monitors, analyzes and works to improve care in order to improve patient outcomes.
The Hospital maintains a Quality Dashboard that summarizes much of its key performance data. It updates the dashboard quarterly. Last month, Barbara Eusebio, R.N., Washington Hospital's associate administrator and chief of Quality and Resource Management and Compliance, presented the results of the most recent dashboardÑcovering the last quarter of 2013Ñto the Washington Township Health Care District Board of Directors. Her report reflected the Hospital's ability to meet a list of Core Performance Measures, prevent hospital-acquired infections, and lower the incidence of certain conditions related to nursing care.
"The Core Measures are associated with treatment for a group of chronic diseases that affect a large percentage of the patients at our Hospital," explained Eusebio. "They include heart attack, heart failure and pneumonia, as well as care for surgical patients. We are focusing on these measures because research has shown, if we follow the recommended treatments, we'll achieve better outcomes for our patients. In most cases, Washington Hospital is better than the quality benchmarks set for the state and the nation."
Core Measure performance
In performing certain steps in the care process for patients with heart attack, or acute myocardial infarction, Washington Hospital was well within state and national ranges. The steps included:
* Performing a coronary angioplasty (PCI) to open a blocked artery within 90 minutes of patient arrival.
* Giving patients an aspirin and a prescription for cholesterol medication at discharge.
"A multidisciplinary team is studying our process for PCIs very closely to help us improve even further," added Eusebio.
For heart failure patients, the Hospital was better than state and national benchmarks in providing the recommended treatments, including:
* Evaluating the heart's left ventricular function.
* Giving patients the proper medication and instructions at discharge.
"When caring for patients with pneumonia, we met the Core Measures 100 percent of the time," reported Eusebio.
Recommended pneumonia treatments include:
* Performing blood cultures while the patient is in the Emergency Department and before an antibiotic was given.
* Providing the appropriate antibiotic.
Caring for surgical patients
For patients having abdominal surgery at Washington Hospital, there are numerous treatment elements included in the Core Measures.
The dashboard showed that the Hospital complied 100 percent of the time with the following steps:
* Selecting the appropriate antibiotic.
* Starting the antibiotic within one hour before surgery and discontinuing it within 24 hours after surgery.
* Checking the patient's temperature during and after surgery.
* Providing certain heart medications during and after surgery.
* Measuring a patient's blood sugar in the intensive care unit after cardiac surgery.
Other steps with which the Hospital had a high compliance rate included:
* Providing treatment to prevent blood clots (99 percent).
* Removing a urinary catheter within one or two days of surgery (97 percent).
The Hospital successfully met these standards in its Outpatient Surgery unit.
"Our surgeons have done an excellent job in making sure we are meeting the performance standards," stated Eusebio. "Patients who come to Washington Hospital for surgery can be very satisfied that they will be well cared for."
Washington Hospital also puts a major focus on preventing hospital-acquired infections. Some of the recommended measures related to the need for placement of a mechanical device into the patient's body, which increases the risk of infection. This includes the placement of central venous lines and urinary catheters.
During the period covered by the dashboard, there was one central line infection and one catheter-associated urinary tract infection at Washington Hospital. In each case, the rate was better than state and national benchmarks.
"There are a number of steps our nurses and doctors take to help prevent central line infections," reported Eusebio. "We have done a lot of work in this area."
The Hospital is also working to prevent multi-drug resistant infections, including C-difficile, MRSA (methicillin resistant staphylococcus aureus) and VRE (vancomycin resistant enterococci). During the time covered by the dashboard, the rate of these infections at Washington Hospital was slightly higher than state and national benchmarks.
"Drug resistant infections are a big problem for most hospitals," said Eusebio. "We employ special cleaning methods to prevent C-difficile and are working to reduce the use of antibiotics. Due to these steps and others, our incidence numbers are beginning to improve."
Finally, Eusebio reported that no patient at Washington Hospital experienced a pressure ulcer during the last quarter of 2013. .
"We have a special program in which we monitor the skin condition of all patients to check for pressures ulcer," she said. "That is an excellent outcome."
You can review more of Washington Hospital's Core Measure data and how it compares to state and national benchmarks by going to Hospital Compare, the web site of the Center for Medicare and Medicaid Services, at www.medicare.gov/hospitalcompare. To learn more about Washington Hospital and its Quality initiatives or to view Barbara Eusebio's report to the Board, go to www.whhs.com.