We’ve said it before, logistics for care doesn’t mean making patients into widgets. The most compassionate and effective care is efficient, well orchestrated care, with a complete understanding of the care activities and needs of all patients everywhere in the hospital at all times. One of the greatest results of a “production system” for patient care is that it puts the patient first by letting doctors and caregivers focus on attentive, responsive bedside care.
To illustrate the point, we posed this question to three hospital CEOs:
How does efficient care coordination improve the quality of care that patients receive?
Dr. Ann Erichetti: The word “efficiency” has such a cold connotation, particularly when you apply it to patient care. It makes it sound like we’re a business. We are, whether we choose to admit that or not; we are in the business of taking care of patients. And being lax, being inefficient…starting with patient throughput…where else does it spill over? Does it spill over into how you deliver care at the bedside? Does it spill over into other processes of care? So it does really matter, and I think that the choice of healthcare organizations to remain inefficient is not going to be a successful choice. I think all of us are going to have to become a lot smarter in using whatever resources we have and using them for better outcomes and using them more efficiently.
One of the very positive outcomes that we’ve seen as a result of this initiative is one that we hoped for but weren’t quite sure how it was going to manifest itself, but we’ve seen a significant trend, an improvement trend in our quality metrics. I’m talking about some basic things, like our bundle compliance, whether it be [unintelligible], whether it be congested heart failure, we’ve been at 100% for the last several quarters. We’ve seen our skip compliance improved from the low 90’s to the 97 percentile. We’ve seen, and I’ll use some abbreviations that I hope the audience will understand, we’ve seen our catheter-related UTI’s improve. We’ve seen our bloodstream catheter-related bloodstream infections improve. We’ve seen our pressure [unintelligible] rates decline. And you might say, “Well, how did this happen with the Care Logistics product, which is focused on logistics and focused on length of stay?” Because by virtue of the fact that we’ve changed how we do business. We have every morning multi-disciplinary rounds: C3, hospitalists, nursing. We’ve embedded more concurrent monitoring into our rounding process, so we now ask: does the patient have a catheter, does the patient have this, does the patient have that, so we can make real-time changes as opposed to maybe kind of losing track of that. So we’re seeing those outcomes significantly improve, and I think it’s because we’re embedding a lot more of that in our daily rounding process.
Dan Moen: One thing’s for sure: there’s a lot of chaos that goes on in hospitals every day, and the Care Logistics system has helped to minimize that by making our flow more predictable, by making our quality better and actually improving our interactions with patients and their families as well. A lot of that is thanks to the care coordination process that’s inherent in the Care Logistics system.
Our mission, and CHE Trinity’s mission, is really to be a transforming healing presence in the communities we serve. And in order to do that we really had to transform ourselves, and this is a system that hardwired some changes into the organization that really needed to happen. We had been making progress in different areas, on quality and safety, but it seemed that whenever we pushed for certain change, it happened for a period of time, and then it sort of trailed off. But the Care Logistics system really does embed these changes in the system, and these are systems that really help the staff do a better job of taking care of patients.
As far as our quality and patient satisfaction scores are concerned, we’ve made some pretty dramatic improvements since the implementation of our Care Connect system. Quality and safety issues certainly we are now approaching, you know, the scores where we think we should be, and that is in top decile kind of performance.
Peter Selman: You know, I think the greatest gift that we can give to the team members here Baptist Medical Center South is time, and a lot of us would say that’s greatest gift any of us can have in this crazy world, but more time with their patients, doctors, nurses, therapists, technicians will tell you if they had more time to spend with their patients, they could deliver higher quality, safer, more efficient, more effective care. So, Care Logistics enables us to do that, electronic medical records enable us do those kinds of things. So I think that’s probably the greatest gift that we can give them. When we drive efficiency out of our organization we become a more streamlined entity, and I think that the ultimate stakeholder in all this, the patient and their family members and loved ones, appreciate that.