Download Report

April 2012
Steven Mendes, MD,
Pediatrician
SOuTHCOAST HEALTH SySTEM & BOSTON CHILDREN’S HOSPITAL
ANNOuNCE NEW COLLABORATION
Improved access to pediatric care for children and families across the South Coast region
S
outhcoast Health System and Boston Children’s Hospital have begun a new collaboration to
provide enhanced local access to high-quality pediatric care to children and families across the
South Coast region.
Beginning in late summer 2012, Boston Children’s and its
physicians will collaborate with local physicians to provide
initiative and for bringing innovative clinical care from Boston
Children’s to Southcoast.”
hospital-based pediatric services for Southcoast.
“We are pleased that Southcoast selected Boston Children’s to
The pediatric program will be centered at St. Luke’s Hospital
help provide care to children and families across the South Coast
with Boston Children’s pediatricians providing 24/7 onsite
region,” said Sandra Fenwick, President & COO of Boston
pediatric care working with local physicians in pediatrics, family
Children’s Hospital. “This collaboration is an extension of Boston
medicine and emergency medicine. A Boston Children’s onsite
Children’s Community of Care, where we work with community
Medical Director will be responsible for medical oversight,
hospitals and physicians to provide high-quality community-based
development and coordination of the Southcoast hospital-based
pediatric care closer to home in lower cost settings.”
pediatric care. Additionally, remote pediatric consultation services
To help enhance pediatric care locally, Boston Children’s will
will be available to the Emergency Departments at Charlton
establish a variety of pediatric training and educational support
Memorial and Tobey.
programs for Southcoast physicians, nurses and ancillary
“We are excited to partner with Boston Children’s Hospital,
departments. Together, Southcoast and Boston Children’s will
one of the country’s top pediatric hospitals, to enhance pediatric
implement and monitor clinical quality standards consistent
inpatient and outpatient care available to families on the South
with the American Academy of Pediatrics and Boston Children’s
Coast,” said Keith A. Hovan, President & CEO of Southcoast
guidelines as well as other appropriate standards to deliver the
Health System and Southcoast Hospitals Group. “Our local
highest quality of pediatric care.
physicians — pediatricians, primary care, family practice and
emergency — have expressed overwhelming support of this
“The affiliation with Boston Children’s Hospital will allow
Southcoast to elevate and improve access to much needed
continued on page 2
INNOVATION
UNITS FOCUS ON
IMPROVING THE
PATIENT EXPERIENCE
5
THE INTERVIEW
Donna Querim, RN
Amanda Szot, RD
8
New Collaboration
continued from cover
pediatric services in the region,” said Steven Mendes, MD,
About Boston Children’s Hospital
a pediatrician with Wareham Pediatrics, Member of the
Founded in 1869 as a 20-bed hospital for children, Boston Children’s
Hospital has been ranked as one of the nation’s best pediatric hospitals
by U.S. News & World Report for the past 21 years. Boston Children’s is the
primary pediatric teaching hospital of Harvard Medical School and the
largest provider of health care to Massachusetts children. The hospital has
395 pediatric and adolescent inpatient beds and 228 outpatient programs.
Boston Children’s also houses the world’s largest research enterprise based
at a pediatric medical center, where its discoveries benefit both children and
adults. More than 1,100 scientists, including nine members of the National
Academy of Sciences, 11 members of the Institute of Medicine and nine
members of the Howard Hughes Medical Institute comprise Boston
Children’s research community. For more information about the hospital
visit: www.childrenshospital.org/newsroom.
Southcoast Boards of Trustees and President of the Medical
Staff at Tobey. “A primary goal of the program is to assist
Southcoast clinicians and community pediatricians with
pediatric care so that families do not have to travel outside
of the region and can continue to receive their care from
their own trusted local physician.”
Southcoast, Boston Children’s and the region’s pediatricians
and family practitioners will work to assess the need for
pediatric specialty services. The assessment will inform the
development of an overarching strategy to provide
enhanced access to pediatric specialty services in the South
Coast region.
RAPPP Celebrates Opening of New Office
T
he Southcoast Hospitals’ Responsible Attitudes toward Pregnancy, Parenting & Prevention
(RAPPP) Program recently celebrated the opening of its new office on Ashley Boulevard in
New Bedford. The office provides area youth with a safe, non-judgmental environment
where they can gather for information, education or to just relax.
“This new location offers many advantages over our previous office
in Dartmouth,” said Cindy Guilbeault, Youth Program Coordinator for
RAPPP. “It is close to the New Bedford Vocational Technical High
School and the Global Charter School, plus it is near a bus stop, making
it much more accessible.”
The open and inviting office offers gathering space for up to 40,
computers with Internet access, Wi-Fi and a sitting area with a television,
Xbox, a stock of video games and a supply of snacks.
To announce the opening, a week-long open house event for
students was held in February and a public open house took place on
March 1.
“We have been seeing more and more young people coming in as
each week goes by,” said Billy Junkins, a Youth Educator. “And we’ve
got students from some of the high schools working on great projects.”
Students from nearby New Bedford Voc/Tech have been doing their
Career Technical Cycles at the RAPPP office, creating public service
From left: Youth Educators Billy Junkins, Charlotte Hamer and Jannine Mitchell.
announcements on quitting smoking and eating disorders.
“The students really come up with some great ideas,” Junkins said.
RAPPP has reached more than 84,000 teens and parents since its
“They even had some insight into how we should organize the youth
inception, including more than 50,000 teens through its in-school
open house week.”
programs at area senior and junior high schools. Learn more about
RAPPP at www.southcoast.org/rappp/.
Upon student recommendation, each day of the week had a
different theme — Movie Monday, Teamwork Tuesday, Friendsday
Wednesday, Sing and Dance Day and Free For All Friday.
“The students who organized the event felt it was important for
young people to get comfortable with the office and each other early
in the week with more low-key activities before advancing to more
interactive events,” Guilbeault said. “It really worked out.”
RAPPP is an adolescent pregnancy prevention program
designed to be used within the curriculum of the health
or science department of high and junior high
school systems. RAPPP also engages adolescents
and young adults in the community through a
number of outreach programs addressing
youth risk behaviors.
COASTLINES
2
H
ise
W
th
l
ea
Looking for ways to improve your lifestyle?
Find online programs to help address emotional health, exercise,
nutrition, smoking cessation, stress management and weight
management at www.southcoasthealthquest.org. Just click on
the Healthy Living tab to connect to specialized readings and
planners to get you on track to a healthier you!
Comprehensive Cardiac Care at Southcoast
O
n April 18, 2002, Southcoast Health System became the first hospital in
Southeastern Massachusetts to perform open heart surgery.
From left: David Teixeira, Director of Interventional Cardiology,
Margaret Ferrell, MD, Medical Director of Interventional Cardiology,
Liz Yokell, RN, and Shawn Whitmore, Cardiovascular Technician.
Ten years and almost 3,000 cardiac surgeries later, HealthGrades
ranks Southcoast among the top 5 percent of hospitals in the U.S. not
only for cardiac surgery but for overall cardiac care.
“Patients in the South Coast region who receive their cardiac care at
appropriate technique for ablation and assess the risk strategy of
patients for sudden cardiac arrest,” said Jagmeet P. Singh, MD, PhD,
a Southcoast hospital can rest assured they are receiving their care at
board-certified in clinical cardiac electrophysiology, internal medicine
one of the top heart hospitals in the U.S.,” said Keith A. Hovan,
and cardiology and Associate Professor of Medicine at Harvard
President & CEO of Southcoast Health System and Southcoast
University.
Hospitals Group. “The HealthGrades rankings are an outstanding
With electronic anatomical mapping, a three-dimensional image of
achievement for our cardiac program and a testament to our
the heart provides a roadmap to target different anatomical regions
physicians and health care providers who are saving lives every day.”
allowing physicians more precise views with which to carry out
Whether patients need open heart procedures, cardiac catheterizations,
angioplasty or pace makers, Southcoast provides the entire spectrum of
treatment.
Other services include permanent pacemaker implants to treat an
cardiovascular services locally — services typically seen in advanced
abnormally slow heartbeat, cardiac resynchronization therapy for congestive
academic medical facilities.
heart failure and implantable cardioverter-defibrillator therapy.
Advanced Care Close to Home
Individualized Care
From routine cardiac catheterizations to complex coronary inter-
At Southcoast Hospitals, each patient is more than a number. This
ventions, Southcoast Hospitals Group brings advanced cardiac services
dedication to personalized services results in positive patient experiences
to the entire South Coast community with superior outcomes.
and care comparable to that of any major academic medical institution
Cardiologists from the Fall River and New Bedford communities
in the country.
perform interventional cardiac services at Charlton while St. Luke’s
“Cardiac services at Southcoast are personal, accessible and of
also offers a full range of diagnostic and cardiac treatment services
extremely high quality,” Dr. Ferrell said. “The multidisciplinary staff is
complimented by a seamless link to the region’s only cardiac
a really nice group, and patients feel that.”
intervention and open heart surgery programs.
Southcoast affirmed its commitment to leading-edge care by being
“It’s a great benefit to our patients to receive consistent care from a
small team of care givers,” said Laurie Mulgrew, Vice President of Clinical
the first community hospital in Massachusetts to perform elective
Services, Cardiovascular Care & Imaging. “When a patient calls with a
angioplasty services at Charlton. Using the same advanced diagnostics
problem, the whole staff understands the case, regardless of who is on
as larger health facilities, Southcoast cardiologists perform more than
call.”
1,500 catheterizations a year — more than any other community
hospital system in the state.
“Our patient satisfaction is extremely high, and patients recognize
A Decade of Caring
In 2002, Southcoast was one of just three community hospitals in
the personal care they receive,” said Margaret A. Ferrell, MD,
Massachusetts to be approved to develop a cardiac surgery program and
Physician-in-Chief of Cardiovascular Services at Southcoast. “The
the first to actually perform the procedure. Now, Southcoast’s cardiovascular
Cardiac Cath Lab provides skilled operators and a fully sophisticated
surgeons perform approximately 300 procedures every year.
facility in a community setting and ambiance. All of our services have
“We're able to perform the same surgical procedures in the same
a community feel with excellent patient outcomes and a collegial
manner with a better patient and family centered approach achieving
working relationship with our surgical colleagues keeps our patients’
similar clinical outcomes in comparison with the major academic
interest at the forefront.”
medical centers in Boston or in Providence,” said Christian T. Campos,
MD, cardiovascular surgeon. “Patients can receive their specialized
A Beat Away
Southcoast’s Electrophysiology (EP) Lab, based at Charlton,
provides patients with the latest in treatment for cardiac arrhythmias
and implantation of pacemakers.
“Southcoast’s state-of-the-art EP lab has provisions to not only
perform routine implant procedures, but to use imaging systems, such
as the electronic anatomical mapping of the heart, to determine the
cardiac care in their own community with the support of their families
and friends, which leads to excellent clinical outcomes.”
With a devoted staff who take pride in delivering high quality care
and an administration that supports the cardiac program, Southcoast’s
full range of cardiac services brings five-star care to the region and
continues the decade-long commitment to improving patient outcomes.
To learn more about the cardiology services available through
Southcoast Hospitals, visit www.southcoast.org/heart.
Take A Step for Heart Health
Saturday, May 5 Heritage State Park, Fall River
J
oin Southcoast as we dedicate the walking trail at Heritage State Park in Fall River in
partnership with the American Heart Association and the Massachusetts Department of
Conservation & Recreation.
The day will include the dedication and inaugural walk on the trail, free health screenings,
educational information, light refreshments and more.
Check your local newspapers and www.southcoast.org for details on this heart healthy
Saturday
May 5
day of education and activities.
Want to track your progress in your walking program? Download the chart at
www.mass.gov/dcr/recreate/hht/.
COASTLINES
3
Southcoast Breaks Ground on New Ambulatory Care Center
S
outhcoast Health System broke ground in March on a two-story, 60,000-square-foot Ambulatory Care Center
that will expand health care services in the community and place a greater emphasis on prevention. The
building is adjacent to the existing Southcoast Centers for Cancer Care site at 206 Mill Road in Fairhaven.
“The push for health care reform is changing the landscape of health
“The Greater Fairhaven community no longer needs to envision a
medical center that brings together some of the best community health
care delivery across the nation,” said Ellen Banach, Senior Vice President of
care available. It is right here — right now,” said Keith A. Hovan,
Strategic Services. “The goal is to keep patients out of the acute care setting
President & CEO of Southcoast Health System and Southcoast Hospitals
and closer to home by focusing on prevention and early recognition of
Group. “The new Ambulatory Care Center will improve access to
illnesses with continual monitoring and follow up care. The new facility
medical care that patients previously had to travel for — better access to
will offer an opportunity for much needed expansion of health care
medical specialists, the very latest diagnostic technology anywhere and
services in the community with a greater emphasis on prevention and
walk-in urgent care.”
treating patients before they become chronically ill.”
Similar to the Southcoast Centers for Cancer Care project, the new
Scheduled to open in Summer 2013, the Southcoast Ambulatory
Ambulatory Care Center building project will create up to 250 temporary
Care Center will include an urgent care center that will accept
walk-in and same day appointments. The center will bring together
construction jobs over the life of the project, while the new center will
approximately 40 physicians, including primary care, family practice,
employ approximately 50 staff members.
surgical and medical specialists. Comprehensive outpatient services
will include radiology, laboratory and cardiac testing as well as a retail
pharmacy similar to the pharmacy at St. Luke’s Hospital.
Southcoast Supports Donate Life America’s
“20 Million in 2012” Campaign
S
outhcoast Health System will again this year fly special “Donate Life” flags at its three
hospital sites for the month of April to bring awareness to the importance of organ and
tissue donation.
“Southcoast has had a long-standing relationship with the New
means 42 percent of individuals age 18 and older are registered as organ,
England Organ Bank (NEOB) and many members of our community
eye and tissue donors,” said David Fleming, President of Donate Life
have shown support by signing up to become donors or granting
America. “With the majority of individuals in the United States wishing to
consent for tissue and organ donation from their loved ones who died
be organ, eye and tissue donors, the biggest challenge to meeting our goal
at one of our facilities,” said Patrick Gannon, RPh, Chief Quality Officer.
of 20 million will be getting people to take action and register as an organ,
“Hospital staff and physicians have also supported tissue and organ
eye and tissue donor at DonateLifeAmerica.org.”
Jolieanne Driscoll of The New England Organ Bank will also
donation by working in collaboration with NEOB staff when families
express consent for a tissue and organ donation to occur.”
Donate Life America, the national organization promoting organ,
be available at Charlton and St. Luke’s during the month to share
information about tissue and organ donation.
“NEOB is proud to be a part of this campaign,” Driscoll said. “It’s very
eye and tissue donation, launched a bold new initiative to register
20 million people in 2012 on their state donor registries.
“Donate Life celebrated 100 million registered donors in 2011, which
important that we continue to increase awareness about organ and tissue
donation as well as let everyone know how simple it is to become a
registered donor. Lives can be saved by taking a few short minutes to
sign up.”
Now — More Than Ever — We Need you!
T
hank you to all of you who have supported the 2012 Employee
restaurants, local shops and some surprising fun items. You have noth-
Appeal. We still need to raise $10,000 to meet our 2012 goal. If you
ing to lose, but we promise you will gain a sense of pride knowing you
have not yet given, you can be one of the generous people who help
have helped your patients and colleagues.
give us the push we need! Whether it’s $10 or $500, your gift means
a lot to our health system.
For those of you, who have already given, send us a message
telling us why you give.
Enter to Win
We would love to hear from you! Simply email us at
Donate to the 2012 Employee Appeal and you will be entered to
[email protected] or call 508-961-5358 to share. Stories will be
win a deluxe gift card package. The basket includes gift cards from
featured in our next issue of Coastlines.
— Amy Winn
COASTLINES
4
Innovation units Focus on Improving
the Patient Experience
W
hen Southcoast became concerned that increasing regulatory and technology demands
were taking a toll on both the patient and staff experience, leadership turned to front line
staff to identify what could be changed and how to go about making improvements.
Naomi Tavares, RN, retrieves equipment from a hub on Atwood 4.
Two Innovation Units — Atwood 4 Medical/Surgical Unit at
Charlton and the Progressive Care Unit (PCU) at St. Luke’s — were
designated to take a closer look at work processes and test changes
that would create a more healing environment for both patients and
staff while making it easier for employees to do their jobs well.
“A look at organizations across the country that have undertaken
Rapid Cycle Change Tests were conducted during a 10-day period
with the solutions in place. Performance metrics were established and
analyzed pre- and post-change with very positive results. “We reduced
stress for the staff and gained valuable time that can be directly
steps to deal with the challenges we were facing showed that those
dedicated to our patients,” said Sharlene McGovern, RN, Nurse
who empowered staff to identify problems and create solutions were
Manager, Atwood 4.
the most successful in creating sustainable change,” said Carol Conley,
RN, Senior Vice President & Chief Nursing Officer.
Conley invited Nurse Managers to make presentations as to why
Establishing Equipment Hubs
For Atwood 4 Medical/Surgical Floor, a pain point was equipment
their units should be designated Innovation Units and Atwood 4 and
that was often unavailable or inoperable when staff needed it. The
the PCU were chosen.
co-creation sessions yielded some surprisingly simple and successful
Conley also looked to Ximedica, a company that specializes in
strategies. Equipment hubs were designated in close proximity to
process engineering for the health care industry, to act as facilitators
patient room blocks. The staff committed to a concerted effort to
and work began this past fall. “I like that Ximedica had no pre-set
return and recharge equipment. Some computers and scanners were
templates for change,” Conley said. “They look to the front line staff
hard-wired in patient rooms. A support system was put in place with
to generate the ideas.”
MIS and Clinical Engineering, so that equipment can be maintained
“No process exists in isolation,” said Kat Darula, Director of Design
Research at Ximedica and a Six Sigma Black Belt. “To be successful, we
and purchased in an efficient manner.
The equipment hubs solution has great value across the organization.
have to have collaborative cross functional work teams identify what
“If it can work on Atwood 4, one of the largest units in the hospital,
needs to change and design the solutions.”
then other units will be able to take advantage of these solutions,”
Conley said.
Smoothing the Transition from the ED
For the PCU, inaccurate, incomplete and missing “must have”
patient information was impeding a smooth Emergency Department
(ED) admission to the PCU and causing a lot of stress for the staff as
they spent time searching for the missing information.
To optimize the process, a tracker system was developed that
enables PCU staff a real-time view of ED admissions, and a beeper
system alerts PCU staff when a patient is ready to be transported to
the unit. A dedicated Admission Team was formed to travel to the ED
to pick up the patient, get introduced to the family and obtain an oral
report on the patient’s status. To improve collaboration and quickly
complete attending physician orders, a hospitalist was brought onto
the PCU.
“The feedback from all involved with these changes was very
positive,” Howes said. “By having PCU staff involved in transport,
there is an opportunity to explain to the patient and the family what
will happen once the patient is in the room. It is a very personal
approach. And having the hospitalist on the floor with us makes for
From left: Jackie Cambra, Nurses Aide, gets a patient admitted from the ED settled into a bed
on the Progressive Care Unit at St. Luke’s while Amanda Medeiros, RN, takes report from
Courtney Cogliano, RN, who greeted the patient in the ED and helped to transfer her.
a very quick resolution of patients’ medication needs.”
Next Steps
Identifying “Pain Points”
A Steering Committee will study the results of the Innovation
The first phase for both Innovation Units was working with Darula
Units’ Rapid Change Cycle Tests and decide how best to spread these
to identify what gets in the way of providing good patient care. These
innovations to other Southcoast units. Along with the work redesign
“pain points” could be large or small. Then the staff selected which
initiatives, Nancy Dluhy, PhD, a nurse consultant, has been spending
initiative to address first. Work teams, consisting of staff members and
time on the floors of the Innovation Units, providing support to the
representatives of the various departments that were involved in the
staff as they make these changes to their workdays and offering
process — for example, Purchasing, MIS and Clinical Engineering —
guidance as more time becomes available for patient and family
met in co-creation sessions to develop solutions for these pain points.
interaction.
“The process of creating solutions took us outside our comfort
While the process for these initial innovations took three months
zone,” said Diane Howes, RN, Nurse Manager of the PCU at St. Luke’s.
from initiative selection through to the Rapid Cycle Change Tests, the
“It forced us to think beyond our routines, something we, who are so
next project will be a collaborative effort involving all three
used to routine for good and necessary reasons, do not typically do.
Southcoast hospitals and will take six to nine months.
But it enabled us to come up with creative solutions.”
“We will be taking on the medication administration process,
which has long been a challenge to staff,” Conley said. “We will rely
on our front line to again use their knowledge and experience to make
improvements to this very important piece of patient care.”
— Chris Rogers
COASTLINES
5
SystemI’m sure by now you have heard the exciting news about our new
Keith A. Hovan
President & CEO, Southcoast Health System
and Southcoast Hospitals Group
• The physicians in our Southcoast Physicians Network are part of New
collaboration with Boston Children’s Hospital to bring hospital-based
England Quality Care Alliance, a 1,600-member strong alliance of
pediatric care to the South Coast. If not, be sure to read the front-page
physicians that constantly advance the level of quality care delivered
article of this issue of Coastlines.
to patients.
The pediatrics program will be centered at St. Luke’s and feature 24/7
onsite pediatric care by Boston Children’s pediatricians who will work
with local physicians in pediatrics, family medicine and emergency
medicine. Remote pediatric consultation services will be available to the
Emergency Departments at Charlton and Tobey, so children from
throughout the region will benefit from the same great care.
How important is this? It’s important on two levels — for us as
parents and for Southcoast as an organization.
Many of us here at Southcoast are parents or have children in our
lives who we love and want to protect, and we know there is no greater
worry than when our children are ill — especially in an emergency
situation. We want to ensure that our children will have guaranteed,
timely access to great quality care at any time of the day or night,
whether or not their own pediatrician is available.
Establishing this program continues to fulfill Southcoast’s mission
of caring for the health of the community and it enables us to provide
top-quality care to our youngest and most vulnerable citizens.
The collaboration is just the latest in a long line of similar partnerships and affiliations Southcoast has established over the years in an
effort to bring the best quality care to the region.
• Our Southcoast Centers for Cancer Care are affiliated with MD
Anderson Physicians Network, a subsidiary of The University of Texas
MD Anderson Cancer Center, which is one of the world's most
respected leaders in cancer care and ranked No. 1 in the nation, by
U.S. News & World Report's "Best Cancer Hospitals" survey for eight
of the past 10 years, including 2011.
• We partner with Tufts Medical Center for our open heart surgery
program and with the Massachusetts General Hospital Heart Center
for our electrophysiology program at Charlton.
Our quality efforts don’t end with these affiliations. This month in
the Quality & Safety Update, Patrick talks about our great achievements
in reducing — and virtually eliminating — the incidence of central-line
infections and pressure ulcers, our improvements in diabetes care and
our involvement with the QUEST program.
• Southcoast has been recognized as a Center of Excellence by the
American Society of Bariatric Surgery.
• The Southcoast Brain & Spine Center is designated as a Blue Cross
Blue Shield Center of Distinction based on best practices and quality
of outcomes.
• Tobey Hospital received Baby-Friendly Designation from Baby
Friendly USA for delivering great care to newborns and their families.
• Most recently the endoscopy unit at Charlton received a "Certificate
of Recognition" by the American Society for Gastrointestinal
Endoscopy for promoting quality in endoscopy. (Read more about it
on page 4.)
• And the list goes on.
We work hard to develop and earn these affiliations and recognitions,
but the effort is worth it. Aligning ourselves with organizations that
provide us access to the latest innovations in care delivery enables us to
raise the bar for our own performance and provide world-class care,
right here in our region. Doing so makes it possible for our family,
friends and neighbors to receive the care they need locally — without
dealing with the stresses of travel and while staying close to their
families, which we know improves outcomes.
You have played a key role in our achievements and your work has
great influence on the quality of care we provide. Thank you for all you
have done and for what you do every day in our quest to provide the
best possible care to our patients.
Financial
Carolyn Allen
CPA, CHFP
Chief Financial Officer
Southcoast Hospitals Group
For the Four Months Ended January 31, 2012
OPERATING RESULTS
For the fiscal year-to-date, Southcoast Health System generated
• Inpatient surgical volume was behind budget by 216 cases, or 7.6
income from current year operations of $9 million. Inpatient volume
percent, through January, primarily in the areas of urological and
was below budget while operating expenses were better than budget
orthopedic surgery. Outpatient surgeries were behind budget by 358
fiscal year-to-date. Income from operations was $5.2 million higher
cases, or 8.2 percent, and the prior year period by 4.4 percent.
than the prior year.
Through January, operating revenues were ahead of budget by $2.5
million, or 1 percent. Volume highlights included:
• Hospital discharges were behind budget by 193 cases, or 1.3 percent,
year-to-date and were 82 cases, or 0.6 percent, behind compared to
the prior year period. Acute length-of-stay of 4.68 days has improved
by 1.9 percent compared to prior year.
COASTLINES
6
• Outpatient diagnostic procedures were better than budget through
January, with outpatient laboratory tests and outpatient radiology
procedures exceeding budget by 2.5 percent and 2.4 percent,
respectively.
• Oncology volume was mixed year-to-date. Medical treatments
exceeded budget by 5.5 percent however, radiation treatments were
short by 21 percent.
continued on page 7
Quality&
Patrick Gannon
Vice President of Performance Improvement
Chief Quality Officer, Southcoast Health System
Do you sometimes wonder if all this work we do around improving
with our endocrinologists (physicians who specialize in diabetes
the quality of the care we provide really working? I am happy to say, that
management) continue to refine the order sheet and protocol to
it is and I have some great success stories to share with you this month.
make even more improvements. A further improved version of the
order sheet and protocol was launched on February 22.
The insulin order sheet review process has worked so well
Journey to (near) Zero
Central Line Infections: In general, our rate of hospital acquired
that various teams are now embarking on the same approach for
central IV line infections has improved. We recently experienced nine
anticoagulation orders (blood thinners), sepsis care (blood infections)
consecutive months of no such infections at Tobey, and three
and stroke care.
consecutive months of no such infections at St. Luke’s, while Charlton
Beyond our hospital walls
has the best overall annual rate for hospital acquired central line
We continue to work with about 200 hospitals as part of a national
infections. Southcoast-wide, we performed 37 percent better in FY11
than in FY10. The improvements reduce the risk of mortality and lower
collaborative project known as QUEST and organized by Premier. The
costs to provide care to patients.
general intent of the collaborative is to learn best practices from each
other, which all hospitals then implement in their organizations.
Pressure Ulcers: Our rate of serious, hospital-acquired pressure ulcers
(bed sores) was zero for five consecutive months, Southcoast-wide — a
fantastic and challenging achievement to sustain! Thanks go out to the
many nurses and their counterpart team members who work diligently
on skin care on every shift.
The results for the first three years of the project are quite remarkable.
For all participating hospitals combined, nearly 25,000 lives were saved
over three years by improving compliance with standards of care for
heart attack, heart failure, pneumonia and surgical care. The combined
number of patients who received these specific standards of care
In other areas: Our weight-loss surgery program — based at Tobey
increased from 18,000 patients in first year of the project to more than
Hospital — performs as much as 75 percent better than other programs
75,000 patients by the third year. From a financial perspective, the
in the U.S. when it comes to serious complications. Our cardiac
improvements in patient care and the associated improved, patient
surgeons are among the busiest coronary bypass surgeons in the state,
outcomes lowered the cost of care by $4.45 billion across the participating
with a complication and mortality rate of less than half (meaning
hospitals.
better than) the national average.
The collaborative is now building on its success by continuing its
Diabetes Care: During 2011, a multidisciplinary team reviewed care
initial work and adding other areas of focus including reduction in
processes and outcomes for inpatients with diabetes. The review
patient harm, improved patient satisfaction/experience and reduced
revealed a significant number of patients whose blood sugar dropped
hospital readmissions. Soon the project will begin addressing the
to levels lower than is healthy for them. In efforts to improve patient
appropriate use of tests, treatments and services to maximize optimal
care and safety, a mandatory insulin order sheet for physicians and
care for patients.
mid-level providers was implemented in October. The sheet helps
While it is important for us to take note of the achievements we
structure the ordering of safe insulin therapy for adult patients — and
have made on behalf of our patients, we also must remember we will
met with great success. In less than three months, Southcoast achieved
never be quite done. Quality improvement is a continual journey as
a 43 percent improvement in reducing very low levels of blood sugar
we “raise the bar” for our performance over and over again. That's the
values as measured by Laboratory testing. The work team, including
mandate, and I think that's what we all expect as potential patients of
clinicians from both inpatient and outpatient diabetes care along
this health care system.
continued from page 6
Year-to-Date
Month of January
Actual
Through January, operating expenses were under budget by
$1.9 million, or 0.7 percent. Expense highlights include:
Average Daily Census
• On a combined basis, personnel services and benefits were
Hospital Discharges
Budget
Difference
Actual
Budget
Difference
610
598
12
563
577
(14)
3,815
3,915
(100)
14,805
14,998
(193)
4.96
4.73
.23
4.68
4.73
(.05)
3,112
3,188
(76)
11,581
12,338
(757)
$695,000, or 0.4 percent, over budget.
• Hospital FTEs and salary costs per adjusted occupied bed
Average Length-of-Stay
(AOB) were better by 0.7 percent and 0.2 percent,
Surgery Cases
respectively through January.
Emergency Room Visits
15,100
14,559
541
59,579
60,237
(658)
Home Care Episodes of
Care (Medicare only)
510
561
(51)
1,896
2,222
(326)
• Supply expenses were under budget by $1.2 million, or
3.5 percent, through January, primarily attributable to the
Hospitals Group, where when flexed for volume, supply
expenses per AOB were under budget by 3.9 percent.
• Other expenses were under budget by $1.8 million
or 4.2 percent through January, due to lower than
budgeted service contracts through January.
COASTLINES
7
the
Interview
Cardiac Prevention Program
Donna Querim, RN, JD
Nurse Clinician
Amanda Szot, RD
Dietitian
The Cardiac Prevention Program was established by Southcoast in
2002 as a community-based program to help educate people in the
region on the dangers and prevention of cardiac disease. The program
initially focused on the adult population, providing blood pressure,
cholesterol and blood sugar screenings and education related to living
a heart-healthy life. Since that time, the program has expanded its
focus to include all areas of wellness — from tobacco use to CPR
education — and it’s audience to include the region’s younger citizens
in hopes of stopping unhealthy behaviors before they begin. Donna
Querim, RN, JD, pictured at right, and Amanda Szot, RD, recently took
time out of their busy schedules to talk to Coastlines about the program.
The Cardiac Prevention Program used to target adults in our
There’s a lot of awareness around childhood obesity and the affects of
community but now includes middle school students. Why did you
nutrition on health. Does the Cardiac Prevention Program address
choose this new segment of the population?
those topics?
Querim: Kids of middle school age are like sponges — they absorb
Szot: Yes. I go into classrooms five times a year to talk about nutrition.
everything they hear. And they are at the age where they are old enough
We encourage students to make heart healthy choices and to try new foods.
to understand the information but are not bucking establishment yet.
I teach students to read Nutrition Fact Labels — understanding this
They are more likely to share the information at home and adopt good
information can help them to determine healthier options and not be
habits before the unhealthy habits set it. They also are naturally curious
misled by food companies’ marketing techniques. We also discuss “portion
and ask great questions. You can tell they are aware of what is going on in
distortion” — how food portions have grown over the past 20 to 30 years
the community and the messages they are receiving through advertising
and how that has resulted in us consuming more calories. We talk about
and are thinking about all of it.
how much activity is needed to burn off those extra calories and what
recommended portion sizes look like.
What other types of education are you providing students?
Querim: In January, we presented the CPR Anytime program to 60
Smoking is still a prevalent problem on the South Coast. Are you
students at Our Sisters’ School, which is a charter school in New
doing anything to teach kids the dangers of tobacco?
Bedford. CPR Anytime is a training kit that teaches the basic skills
Querim: We are now presenting Tar Wars, Southcoast’s anti-smoking
in adult and child CPR and choking relief. It also teaches how an
education program, to sixth grade students. Again, the key is to get to
Automated External Defibrillator (AED) works. The course only
the kids before they develop the bad habits and when they are at the
takes about 20 minutes. And while it doesn’t provide users with CPR
age where they will go home and talk to their parents about the dangers
certification, it does provide the basic skills to help save a life while
of smoking and tobacco use.
help is on the way. The kit is bilingual in Spanish and English and the
students were able to take their kits home to teach their families.
Szot: We are also including discussion of the many smokeless tobacco
products that are becoming so prevalent. Kids need to be aware of the
danger of these products because they can create a nicotine addiction
without a person ever smoking a cigarette. And students can be given
COASTLINES is a monthly publication produced
by the Marketing & Public Relations Department of
Southcoast Health System. Copyright ©2012 by
Southcoast Health System. All rights reserved.
Editor
they look like. Some are in the form of candy that looks like tiny mints,
dissolvable strips that are placed on the tongue like breath freshening
strips and even tooth picks.
Patricia Giramma
Graphic Designer Jane Tucker, Stephen Preston
Contributors
these products by friends without even knowing it because of what
Carolyn Allen, Patrick Gannon,
Keith A. Hovan, Stephanie Poyant,
Chris Rogers, Amy Winn
Photographers Christine Azevedo, Stephen Preston
There seem to be a lot of community-based initiatives around healthy
living. Does Southcoast take part in any of them?
Querim: We are involved in quite a few of them, including Voices for
a Healthy SouthCoast and the Go Red Campaign to increase cardiac
awareness in women and many others. Through Health City Fall River
Address inquiries to: Editor, Coastlines
Marketing & Public Relations, Southcoast Health System
101 Page Street, New Bedford, MA 02740
[email protected]
we are starting to work with smaller businesses that do not have the
resources to have their own wellness programs, providing health
screenings and education. We also have begun working with local
school systems on their wellness policies.
COASTLINES
8