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Commitment to Quality
Report to the Community
May 2009
Commitment to Quality
Washington Regional’s commitment to excellence – evidenced in each area of care –
draws patients from across Northwest Arkansas and beyond. The excellence for which
Washington Regional is known is reflected in its well-respected physicians, specialized
nursing staff and unique combination of resources, innovation and expertise.
The
needs of Washington Regional patients are as diverse as their backgrounds, but they all
share one common desire: to have access to the best healthcare when they need it.
Commitment
throughout
to
quality
the
healthcare system.
is
pervasive
Washington
Regional
We routinely practice
continuous evaluation and improvement of
the
processes
used
to
provide
quality
healthcare for our patients. Ours is a culture
of perpetual learning and improvement -- a
culture of awareness where all employees are
invited to take part in quality improvement
activities such as training sessions, problem identification and resolution, brainstorming
and implementing improved processes and, equally important, evaluating their success.
We set the bar of excellence high. We’re tough on ourselves because that’s what it
takes to be the best we can possibly be for our patients and their families.
A universal thread that weaves through the fabric of daily life at Washington Regional is
the high quality of care and services that patients receive during their stay. Washington
Regional’s commitment to extraordinary service leads us to measure satisfaction
through surveys and interviews of patients, families, physicians, employers and others
who tell us about their experiences at WRMC.
The Most Trusted Name in Healthcare
Independent survey research shows Northwest Arkansas residents consistently
rank Washington Regional as the area’s best hospital, with the best overall
quality, best doctors and nurses, and the best care in a variety of specialty areas
from senior health to cardiology to women’s services.
Regardless of the patient’s ability to pay, in 2008 Washington Regional:





Served more than 50,000 patients in our emergency department
Logged more than 107,000 outpatient visits
Admitted more than 14,000 patients to our medical center
Performed more than 8,700 surgeries
Had over 144,000 clinic visits
Quality of Care: It’s What Sets Us Apart
We are proud of the fact that our quality care ratings consistently exceed national
standards.
Hospitals can vary in the quality of care they provide. Key quality
measurements are one way to see how well a hospital is caring for its patients.

The average length of time patients remained in our
hospital was 4 days. That’s 7% lower than expected,
and translates to people getting back to their work and
their lives sooner, at a cost savings to the community and
to businesses.

30-Day hospital readmission rate for 2008 is 7.5%, 33%
better than the expected rate of 11.2%.
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Washington Regional’s focused quality initiatives continue to save lives while also
saving millions of dollars in health-related costs to employers in Northwest Arkansas.
We pride ourselves in leading the way to improved healthcare for everyone living and
working in Northwest Arkansas. Our quality initiatives are leadership-driven and reflect
a system-wide desire for performance improvement. Initiatives in place at Washington
Regional include:
•
Intensivists Program
•
Hospitalists Program
•
Transformation of the Intensive Care Unit Project
•
Institute for Healthcare Improvement 5 Million Lives Campaign
•
Hospital Glycemic Control
•
Rapid Response Team
•
Sepsis Team
•
Deep Venous Thrombosis Prevention
\
 Overall glucose (blood sugar) control in open heart patients, means
earlier healing & lower risk of infection and other complications –
 98% compliance (15% BETTER than the state average; 13%
BETTER than the national average)
 Overall hospital blood stream infection rate (sepsis) in patients
following surgery – 1.2% (25% BETTER than the expected rate)
 Overall DVT prophylaxis given to surgery patient, (treatments for the
prevention of life threatening blood clots) – 97% compliance
 (17% BETTER than the state average; 13% BETTER than the
national average)
 Overall incidence of PE/DVT in surgery patients, (life threatening
blood clots) – 1.04% (32% BETTER than the expected rate)
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We are particularly proud of outstanding clinical achievements in several areas where
rigorous clinical initiatives have been introduced as standard practice. Blood sugar
control in patients who have had open heart surgery, sepsis control and blood clot
control have resulted in remarkably positive patient outcomes.
Our patients have
benefitted from quicker healing times and less time in-hospital, with fewer re-admits due
to post-hospitalization complications.
Awards
Washington Regional Medical Center was honored to receive two prestigious awards in
the past year.

VHA Regional Clinical Improvement Award for Core
Measures Performance – Heart Attack/Surgical Infection
Preventions
VHA Inc., a national health care alliance, bases this award
clinical work started and completed in 2007.

2008/09 Consumer Choice Award
Presented to WRMC for the 6th year in a row by the National
Research Corporation, this honor goes to the top medical centers
in over 100 markets nationwide. It recognizes our Medical Center
for providing exceptional customer service and consistency.
Celebration of Milestone Events
Originally constructed in 2002, Washington Regional Medical Center recently completed
a $64 million expansion. A campus-wide celebration was held last summer to celebrate
our new North Hills Campus location which includes a new fifth floor with a chapel,
expanded Emergency Department, Pat Walker Center for Seniors, Center for Support
Services and expanded kitchen and pharmacy. Washington Regional Wound Care
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Clinic also moved to its new home on Appleby Landing, immediately adjacent to the
medical center complex.
Washington Regional – North Hills Campus (2008)
Construction Award
Another cause for celebration came in the fall when the 2008 Landmark Award was
presented to Washington Regional by the Fayetteville Chamber of Commerce Board for
the construction of the Pat Walker Center for Seniors. The Landmark Award recognizes
the construction industry for their efforts to make Fayetteville a better place to live, work
and play. Part of this recognition is to showcase a company that has not only been a
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great contributor to the community, but has also constructed a recognizable landmark
that compliments Fayetteville giving a favorable impression when people visit or are
looking for a place to relocate.
Pat Walker Center for Seniors
Another Monumental Move
A very important piece of Washington Regional history has moved
to its rightful place at our North Hills Campus. Our own replica of
the famed Statue of Liberty was transported with loving care from
North College and now stands proudly at her new home atop a
brick pedestal outside the main entrance of the Medical Center.
The statue was sponsored by the Boy Scouts, area civic clubs,
veterans groups and individuals of Washington County. The late
John Lewis, Washington Regional board member and community leader, was one of
the Boy Scouts present when the statue was unveiled to the public in 1951.
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Norma Ebbrecht Courtyard
The rich history of Washington Regional extends far beyond bricks and mortar. Our
most important legacy lies in the incredible women and men who work here every day,
selflessly giving of themselves to others without expecting anything in return. Another
significant chapter of Washington Regional history came to a close last summer with the
retirement of our beloved veteran nurse, Norma Ebbrecht.
Some 43 years ago, Norma began a remarkable nursing career at Washington
Regional. By forgetting herself as a new, young nurse, she actually found herself and
her calling. From caring at the bedside to nurturing and mentoring, probably 2 or 3
thousand nurses, she has created a lasting legacy of caregivers. All this for 43 years at
one very fortunate hospital. The Norma Ebbrecht, RN Courtyard, a tranquil respite for
staff, patients and visitors, will serve as a reminder of her great dedication and
longstanding friendship.
Norma Ebbrecht, R.N.
August 2008
In many ways, Norma’s career reflects the best of Washington Regional -- endurance in
the face of the many changes, obstacles and challenges. And, in particular, the attitude
it takes to thrive for so long… “No matter what, I’m going to do it right anyway.”
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Growing to Serve
Springdale Center for Health
To further enhance its mission of serving the people of Northwest Arkansas,
Washington Regional Springdale Center for Health is now able to deliver quality and
convenience to more patients. Located on Founders Park Drive in beautiful Har-Ber
Meadows, our newest outpatient facility offers the following specialties:

Imaging – Digital Screening Mammography, Bone Density,

Digital X-Ray, Ultrasound and EKG

HerHealth by Washington Regional offering prenatal care, gynecology, and
infertility services

Outpatient Laboratory
Washington Regional Clinics
In Fayetteville, the Washington Regional patient services have expanded to include two
new clinics.

The Northwest Arkansas Neurological Institute, located on N. Futrall Drive,
provides diagnosis and treatment for a variety of neurological disorders, including
muscle weakness, neuropathy, migraine, stroke, movement disorders, epilepsy,
dizziness, Parkinson’s disease and multiple sclerosis. Larry Armstrong, D.O. and
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Regan S. Gallaher, M.D. specialize in neurological surgery and Brent Weilert,
M.D. is a certified specialist in pain management.

Ozark Urology, located on North Hills Boulevard adjacent to the hospital, offers
a broad range of urological services.
Board certified urologist, Richard
McWhorter, M.D., treats all types of urologic related conditions, including urinary
obstruction, prostate disease, infection, kidney stones, male sexual dysfunction
and incontinence.

Washington Regional Family Clinic – Fayetteville, relocated last year to its
new home at the Fiesta Square Shopping Center on North College Avenue.
Clinic physician, John Adkins, M.D. is certified by the American Family Practice
Board and has over three decades of experience treating patients in Fayetteville.
New Physicians
As a vibrant and expanding healthcare system, we recruit both primary care physicians
and specialists to our medical staff on a continual basis. With more than 350 doctors
and healthcare providers on our medical staff, Washington Regional has the expertise
needed by our patients in most branches of specialized medicine and surgery –
including leading experts in cardiac surgery; vascular interventions such as carotid
stenting; neonatology; and interventional radiology.
In 2008, Washington Regional
welcomed 35 new physicians in a variety of specialty areas.
Of special note, in September, Stanley Bradley, M.D. joined Washington Regional
Hospice as its full time Medical Director. Dr. Bradley makes home visits to hospice
patients in Washington, Benton and Madison counties and will be available for hospital
consultations as well as physician and community education. Washington Regional
Hospice is the only agency in Northwest Arkansas with a board-certified hospice
physician as medical director. Medicare certified, Washington Regional Hospice is also
the only area hospice accredited by the JCAHO (Joint Commission on the Accreditation
of Healthcare Organizations). JCAHO sets standards for U.S. healthcare organizations
and issues accreditation to organizations that meet those standards.
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Information Technology:
Another Step Forward
In 2006, the hospital’s newly formed Physicians
was
Advisory Group met for the first time. Between
recently rated in the top 1%
them, the sixteen-member group represented
of
the full spectrum of medical specialties at
Washington
over
Regional
5,000
hospitals
nationwide for progress in
WRMC,
completing
oncology, pharmacology, surgery and many
the
goal
of
creating a paperless patient
including
cardiology,
obstetrics,
more.
record environment.
Among their many duties, the group was tasked
with helping design and guide the development
and
implementation
of
a
comprehensive
Electronic Medical Record (EMR) system for
the hospital that would meet the exacting standards required by their colleagues as well
as the entire team of healthcare professionals working throughout WRMC. It was, to
say the least, a massive undertaking, but everyone involved was dedicated to
completing this crucial project the right way from the ground up.
After nearly five years of working in close partnership
with dozens of technology and health information
systems experts, the EMR system is near completion.
The Computerized Provider Order Entry (CPOE)
segment of the EMR system took 18 months to build
and another 9 months to “roll-out” the CPOE segment
throughout the hospital and to train physician users.
CPOE delivers treatment information to every member of a patient’s care team
throughout the hospital with extraordinary speed and accuracy.
Up-to-the-minute
patient care information is sent to patient units, laboratories, imaging, pharmacy, dietary
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and dozens of other departments when a physician presses the “send” key on a PC in
the hospital, their office and, for some, even at home.
In 2008, $1.5 million was dedicated to bringing the CPOE segment of our EMR online.
All told, Washington Regional’s comprehensive EMR system represents a total financial
commitment of over $9 million.
Improving the health of those we serve includes
investing in technology that supports our steadfast dedication to providing quality patient
care for our community.
While the CPOE is highly efficient and helps optimize patient care, it is not a
replacement for doctors and nurses talking to one another about caring for their
patients. The CPOE is another tool that our physicians can now utilize to provide even
better care for their patients at Washington Regional, but it does not replace the allimportant human element in healthcare. What it does do is help us to provide accurate,
timely care for patients and the time saved allows doctors and nurses to spend more
one-on-one time with their patients.
Giving Back to Our Communities
Washington Regional is grounded in the
community, supported by the community,
and empowered by the community—all in
service of our mission to “improve the health
of people in the communities we serve.” We
are fortunate that a caring, giving spirit is
found in such abundance in our community.
Community benefit is a measurement of the
total amount of money, time and resources
that are dedicated to provide care or promote
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health and healing in response to identified community needs. Community benefits are
not items or programs generated primarily for marketing purposes. We measure the
success of our charitable mission through the benefit we provide to our community.
Improving the health of the region is an enormous task, one that no organization can do
alone.
Our work would not be possible without partnerships with other nonprofit
agencies, health-care providers, corporations, foundations and community leaders.
Together, we are making a difference and creating the kind of healthcare system that
everyone in Northwest Arkansas deserves.
In 2008, Washington Regional provided nearly $1 million in community benefits to
improve healthcare in the broader community including:
 Subsidized health services provided through
the Clinic for Senior Health
 Helping fund a free Prenatal Clinic that is
managed by Washington County Department
of Health
 Providing funding, staffing, and support to the
HIV Clinic operated by the Washington County
Department of Health
 Providing funding to the Fayetteville Free
Health Clinic
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The Economics of Quality Care
In 2008, the COST of providing care to individuals qualifying for
financial assistance from Washington Regional, according to its policy,
was approximately $3,813,441, a marked increase over the same
period in 2007.
Additionally, the cost of providing healthcare to Medicaid recipients,
beyond the reimbursement received from Medicaid, was $5,546,498
Longstanding public policy allows Washington
Regional
to
operate
as
a
not-for-profit
organization. Instead of paying taxes, we
provide benefit directly to the members of our
community.
In 2008, Washington Regional provided
$10,274,036 million in community benefit,
including $9,359,293 million spent directly
caring for members of our community with
limited resources and inadequate medical
insurance
coverage.
This
$9,359,293
million marks a 24% increase in total
uncompensated care.
Our charity care is much more than just “nice
to have.”
It is an essential part of our
community’s response to issues of poverty and
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lack of health insurance. Without the charity care we provide, many of our friends and
neighbors could go untreated – a choice we find simply unacceptable.
At Washington Regional, the same high-quality, compassionate care is provided to
everyone who seeks treatment from us—regardless of their ability to pay. Just as
important as the dollar amount, however, is the caring, compassionate manner in which
we provide charity care.
Expanding community outreach
More than anything else, our partnership with the community is what breathes life and
meaning into our pledge: Here for You…for life. These five words give powerful voice to
Washington Regional’s unique relationship with the community it serves—a message of
unity, interdependence and shared responsibility for meeting our community’s
healthcare needs.
As a healthcare leader, Washington Regional understands the value of prevention and
wellness. That’s why we are proud to be a partner with some of Northwest Arkansas’
most outstanding organizations – groups that share our commitment to improving the
health of those we serve. In 2008, some of our community partnerships include:

Race for the Cure -- Ozark Affiliate of Susan G. Komen for the Cure

Go Red for Women Luncheon -- American Heart Association

Life Styles

Alzheimer’s Association

National Kidney Foundation

Sweat Hawgs

Campaign for Healthier Babies
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Family-centered improvements
In 2008, a generous gift from Procter & Gamble
provided support for helping develop a happy, positive
environment for pediatric patients and their families in
Washington
Regional’s newly expanded Emergency Department.
The corporation’s Live, Learn and Thrive program
funded the creation of a series of original, airbrushed
murals designed to delight young hearts and stir the
imaginations of youngsters visiting the Emergency
Department.
Additionally, a special Cinema Room
was created, and is decorated with airbrushed walls
along with a 42” flat-screen television and a colorful
array of children’s furniture and learning toys.
If you build it, (and invite them), they will come…
Information + Insight + Understanding = Strong Community Bonds. In 2008, a new
initiative was added to Washington Regional’s ongoing effort to increase community
awareness related to our role in improving the health of people in Northwest Arkansas.
The WRMC Ambassador Program invites business leaders to learn firsthand about the
quality and commitment of our healthcare system by spending one-on-one time with
representatives from our leadership and patient care teams.
Ambassador program
participants get a behind-the-scenes tour of our North Hills Campus, including the
Medical Center, the Pat Walker Center for Seniors and the Center for Support Services.
Response from the business community to this unique learning opportunity has been
enthusiastic and plans are underway to expand the program to meet the growing
demand.
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Challenges: Our Doors to Opportunity
Our organization has not been immune from the effects of the most severe economic
crisis to confront our nation in 75 years. As is the case with the majority of hospitals
throughout the nation, and businesses in general for that matter, Washington Regional
must confront a “perfect storm” of issues that have been compounded by or are directly
attributable to the current economic crisis. These include:

Increased unemployment and reduction in employer provided
health benefits has resulted in an increased number of citizens
in our community being unable to pay for care received at the
hospital and throughout our health system which has led to a
dramatic increase in charity care and bad debt.

Increased market competition from for-profit providers.

Overarching obligation to meet needs of community.

Increased pressure on debt and capital reserves attributable to
the on-going need to invest in costly technology.

New & expanding regulatory requirements

Attaining viable, sustainable operating margins with declining
reimbursement and rising costs.

Declining volumes and associated revenues resulting from
patients deferring discretionary or optional services.
Each of these issues presents a challenge for Washington Regional. Of most concern
is the dramatic increase experienced in bad debt. From 2007 to 2008, bad debt has
risen 24% or $4.4 Million Dollars.
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Pictured left to right: Jennifer Bonner, RN (ICU); D. Lee Gray, M.D. (Emergency
Medicine); Monte Gagliardi, EMT (ED); Aaron Leslie, patient; Kelly Janssen, CCRN
(ICU); Jon Sexton, M.D. (Intensivist); Christina Morris, RN (ED)
When charged with addressing the financial challenge Washington Regional is
experiencing, our leadership believed it important to develop a plan that preserved the
employment of all employees and did not result in Washington Regional contributing to
the overall economic difficulties being experienced within our community and nation.
Implementation of an across-the-board reduction in employee compensation and
bonuses, coupled with even greater controls on materials purchasing and labor
management have made it possible for us to avoid employee lay-offs. Our efforts to
find a solution short of a layoff were inspired further by the words of President Obama,
who noted in his inaugural address that it will be collective sacrifices such as the
”selflessness of workers who would rather cut their hours than see a friend lose their
job” that will see us through the current economic crisis.
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We are clearly unable to control much of what confronts us as any service industry is
dependent upon the health of the overall economy. What we can do is confront the
challenges with a firm commitment to our mission – providing the highest quality patient
care to the citizens of our community – and caring for each other. We firmly believe that
the fear and uncertainty inherent in our current times will be overcome by genuine
concern for one another and collective sacrifice. Together we will come through these
challenging times stronger and better!
From the Foundation
Since the hospital’s founding in 1950, the community and its support have been
essential to Washington Regional’s growth and advancement. Community support has
been significant and meaningful, helping to provide for essential programs not covered
by patient revenues and providing for new and enhanced services.
With reimbursements declining and medical equipment and technology costs
increasing, support from the community will continue to be an essential source of
revenue for Washington Regional. We are fortunate that a caring, giving spirit is found
in such abundance in our community.
Expansion Campaign: Steady Advancement
The Rise & Sh!ne Campaign to help fund our $64 million expansion is still underway.
Current pledges and gifts total $11 million toward our goal of raising $14 million for the
project. The campaign is at 79% of goal.
Rise & Sh!ne Together, the employee segment of our expansion campaign, has raised
over $287,000 from 801 employees, representing a 43% participation rate, well above
the national participation rate of 29% for similar campaigns.
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Washington Regional Medical Center Auxiliary made a gift of $500,000 and several
large gifts have already been committed to the campaign including two pledges from the
Willard and Pat Walker Charitable Foundation totaling $5 million. The medical staff
campaign raised $429,757.
Special Events: A Banner Year!
The 2008 Washington Regional Hospice Garden Party raised over $185,000, a record
for this event.
The 2008 Washington Regional Gala, “An Evening with Righteous
Brothers,” was a winner with the community, raising over $78,000 for the Foundation.
Building on Our Past, We Focus on the Future
As we envision the future of Washington Regional, it's vital we remain grounded in the
hospital's longstanding heritage in Northwest Arkansas. Washington Regional’s mission
is enduring because it is our greatest strength. It is why most of us choose to work
here, and it is the reason we enjoy incredible community support.
To serve our mission means to provide the best care, centered on the patient and
family, regardless of a family's ability to pay. The experience of the patient and family
as well as the compassion we show is at the heart of what happens throughout our
network of services everyday.

Patient satisfaction is at the highest level, with 90% of our patients “very
satisfied/satisfied” with their experience, as related to an Independent third
party surveyor – putting Washington Regional in the “top one third” of hospitals
nationally.
Our aspiration is simple but powerful:
We will provide the best healthcare for our
community. To provide the best care, which encompasses the best experience, we will
challenge ourselves to improve the way we do what we do. At Washington Regional,
we believe we have the innovative culture and staff to imagine, create and define the
model world class healthcare system for our community, now and in the future.
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