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| Physicians Lead the Charge for Quality and Safety |
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f we were in any other industry, we would not be content with 99 percent quality or safety,” says Dr. Charles Riccobono, chief quality officer of HUMC. “The airlines |
don’t set a goal that only 1 plane in 100 will crash every year. And yet in healthcare, we’ve been given a pass up until now because of the complexity. The good news is that increasing transparency has created a dramatic change for more collaboration among hospitals.” |
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Getting Results
At HUMC, a large percentage of the organization’s 2007-08 goals are centered around meeting specific quality and safety goals. These organizational goals cascade throughout the organization and align to HUMCdeveloped leadership performance metrics in Leader Evaluation Manager. For example, one goal is to decrease actual mortality by 25% by building reliable processes of care through concurrent and retrospective activity and program development. (See sidebar.) |
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| Where do the metrics to measure performance come from? HUMC uses a combination of internal benchmarks, participation in industry collaboratives, and key national award criteria. The results? HUMC ranks in the top decile of nearly 300 hospitals participating in the CMS/Premiersponsored Hospital Quality Initiative Demonstration in four of five clinical focus areas. The hospital was ranked among those that provide the most advanced and safest surgical care in the nation with fewer complications than most of 120 other hospitals that participated i a 2006 American College of Surgeons National Surgical Quality Improvement Program. HealthGrades also ranked HUMC as one of America’s Best Hospitals based on superior clinical outcomes for seven consecutive years. HUMC also holds 13 disease-specific care certifications, the most in the nation. |
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Engaging Physicians
HUMC credits its high physician engagement to a combination of things. First, Mr. Ferguson, HUMC’s President and CEO, empowers physicians with resources and support for projects they are passionate about. “Mr. Ferguson had a vision, turned it into a promise, then into a plan and in an iterative way we keep getting better and better at delivering patient care,” explains Dr. Peter Gross, senior vice president and chief medical officer. |
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| In addition, systems and teams support engagement and results. Senior leaders identified and educated a core group of physician champions who the medical staff would trust and built systems that make it easy to do the right thing at the right time. HUMC’s Advance Practice Nursing Model, for example, makes it easy for physicians to comply with performance measures. (APNs are trained in disease-specific areas and contact physicians when patients are not compliant with specific measures). Service line teams—which also include non-employed physicians—were also set up in all major areas and dramatically multiplied the number of champions. At HUMC, physicians lead assessment groups to assure compliance with performance measures from the CMS-Premier, Joint Commission and IHI core measures, creating more opportunity for physicians to impact clinical outcomes in their own disciplines. |
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| Physician education is also key. When a monthly HealthGrades report uncovered a documentation problem that negatively impacted HUMC’s case mix and risk adjustment, Dr. Riccobono invited HealthGrades to speak to large groups of physicians about the importance of good documentation to support the practice of good medicine. |
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| The final piece—accountability—is coming soon as HUMC readies to implement new leader evaluation goals and measurement metrics that link to pay practices in the organization as a whole. Physicians, who are receiving individual coaching on developing strong goals and measurement metrics, are enthusiastic about an evidence-based method to track progress. |
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| “The Institute of Medicine and the Institute for Healthcare Improvement have sounded the alarm about the urgent need to build better healthcare,” adds Dr. Louis Teichholz, chief of cardiology and medical director of cardiac surgery. “Now it’s up to us to make it happen.” |
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HUMC is aligned for results. |
HUMC uses a five pillar framework to align each of its strategic directions with global measures for best in class (as described above) and integrate them vertically with executive level metrics for operational performance.1 Each of the five pillar areas is weighted (but wieghts may change from year to year) to focus and align goals as they cascade to all leaders. |
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 Click here for a larger graph.
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Note: HUMC is not yet tracking each of these metrics in leader Evaluation manager. The Hospital is early in the process of identifying and testing metrics that are reliable to track and benchmark internally. |
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How HUMC Casscades metrics to Reduce Mortality |
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Top-rated organizations by HealthGrades have low mortality rates. View a flowchart of how HUMC’s 2007 strategy for reducing mortality cascades to metrics for physician leadership goals organizationwide by clicking here. |
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View more results in quality. |
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View HUMC’s year 1 and year 2 rankings among all hospitals participating in the CMS/Premier sponsored Hospital Quality Initiative Demonstration project by clicking here. |
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