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BryanLGH Health System

  • Location: Lincoln, NE
  • Award: Evidence-Based Leadership Healthcare Organization of the Month
  • Awarded: February 2012

BryanLGH is honored to be recognized as an organization that is improving the patient experience throughout our Journey to Excellence. We have learned from other Studer partners and welcome this opportunity to share our story.

Our achievements to date were realized through a unique, collaborative environment of focus and commitment for our patients. Front-line staff members, with the support of our leadership team and medical staff, are responsible for our measurable positive outcomes.

About BryanLGH

BryanLGH Health System includes BryanLGH Medical Center, Crete Area Medical Center, BryanLGH Heart Institute, BryanLGH Physician Network, BryanLGH LifePointe and the BryanLGH College of Health Sciences.

Our Medical Center's Mission
To provide excellent care and promote health with a focus on quality, collaboration and compassion.

Our Vision 2015
To be the premier medical center in the region through collaboration and the relentless pursuit of excellence.

BryanLGH East
BryanLGH East

BryanLGH West
BryanLGH West

BryanLGH Medical Center is a 672-bed, not for profit, locally owned, healthcare organization serving patients from throughout Nebraska, as well as parts of Kansas, Iowa, South Dakota and other states in the region. The Medical Center includes two acute care facilities.

Crete Area Medical Center is located 25 minutes from Lincoln. Its Physician's Clinic recently earned recognition as one of only three medical home practices in the state.

Crete Area Medical Center
Crete Area Medical Center

BryanLGH Heart Institute is on the leading edge of research and specializes in minimally invasive cardiothoracic surgery, electrophysiology, atrial fibrillation, congestive heart failure and more. Our 17 physicians serve more than 30 communities across four states.

BryanLGH Physician Network practices include family medicine, internal medicine, maternal-fetal medicine, neonatology, plastic and reconstructive surgery, psychiatry and urgent care.

BryanLGH LifePointe is our medically based health and wellness facility with innovative programs, state-of-the-art equipment, spa and Lincoln's most comprehensive team of therapists and coaches.

BryanLGH College of Health Sciences offers graduate and undergraduate degrees through its School of Nursing, School of Health Professions and School of Nurse Anesthesia.

PEOPLE: Achievements

Your Feedback is Udderly Important!

Our 2011 employee engagement survey was conducted by the Advisory Board. We are excited to be able to gauge and improve our employee engagement based on best practices across the country. This year we focused on an extensive communication plan regarding the survey, including a fun theme and are please that we achieved 96 percent participation in our Fall 2011 survey.

SERVICE: Achievements
Patient Satisfaction

In the last six months, we're proud of significant increases in several HCAHPS composite ratings.

BryanLGH Medical Center Inpatient HCAHPS Results


Composite

Avatar database percentile
Jan. 2011 - Jun 2011

Avatar database percentile
Jul. 2011 - Dec. 2011

Communication with nurses

75

88

Communication with MDs

51

75

Communication about meds

48

80

Responsiveness to staff

63

74

Our staff continues to be committed to ensuring we remain ever patient focused. We have been implementing Must Haves® for several years, but have gained a lot of traction in the last six months. We attribute these improvements to implementation of:

  1. Hourly patient/safety rounding
    • Our pilot began July 2011 with medical center wide implementation in Oct. 2011. We anticipate continued improvement as this becomes hard-wired
  2. Increased validation of AIDETSM
    • AIDETSM was implemented over two years ago and needed a 'refresher'. We created a Computer Based Learning module for all staff to refocus on the why of AIDETSM and align to our Mission and Values. We also added a nurse leader patient rounding question to validate use of AIDETSM in patient care areas.
  3. Refocused on communicating patient medications and instructions at discharge
  4. Increased collaboration and partnering with our emergency department and hospitalist physicians
    • We've aligned Studer physician coaches to help coached each MD on their individual patient satisfaction data
    • Trained physician groups on the Must Haves® of AIDETSM and managing up.

http://youtu.be/uCyih5mNVs0

We also are thrilled to have achieved the 90th percentile for the quietness of the hospital environment and formaintaining our willingness to recommend and discharge information composites above the 90th percentile for 2011. Our unit patient experience data continues to climb with several units surpassing the FY12 goal of the 80th percentile.

Inpatient - FY 2012

BryanLGH BryanLGH

Cardiac and OB/Women's Health Recognized for Reaching the 90th percentile in Avatar's database

Physician Satisfaction
We are excited to have moved from the 68th percentile to the 79th percentile in Likelihood to Recommend Family and Friends to our Facility. After our 2011 survey, leadership visited eighty physician offices to share feedback and obtain their input on the year moving forward. We've changed OR schedules, expanded radiology coverage and worked to implement single sign-on based upon their feedback. We're excited to see the results of our upcoming February 2012 survey.

QUALITY: Achievements

We are excited that our efforts the past three years have results in improved care for our patients. We have realized decreased rates in ventilator associated pneumonia, central line infections, medication errors, surgical site infections and most importantly decreased mortality.

Almost three years ago, we instituted concurrent review for the care provided to our pneumonia, heart failure and acute myocardial infarction patients according to the CMS and Joint Commission ORYX requirements. We brought together members of our interdisciplinary team, including physicians, to identify why we were not always able to achieve 100 percent perfect care according to the guidelines. An example of this collaboration included the creation of an antibiotic selection tool for use in the Emergency Department to ensure use of appropriate antibiotics. In the Emergency Department, we have met the CMS/ORYX indicators 100 percent of the time for more than one year for the pneumonia, acute myocardial infarction and congestive heart failure patients.

Infection Control and the Intensive Care Units have worked closely to implement a protocol for how to manage ventilator supported intubated patients, which included a strict regime for oral care. After education and implementation of the protocol, the rate of ventilator-associated pneumonia dropped to less than one-half the national rate, and has remained there for two years. The same group, with the addition of the Purchasing department, selected a new central line dressing kit and changed the way central line dressings were performed. The central line infection rate is now 0.5 central line infections per 1000 ICU hours per year.

We credit the great working relationship between Pharmacy and Nursing for the successful implementation of PYXIS, a medication dispensing system and MAK, a bedside point of care medication management system. These two initiatives have significantly changed pharmacy and nursing practice to improve medication safety. With these two new systems in place and careful analysis of all medication errors, we have been able to reduce the number of medication errors that harm patients by more than 56 percent in 2011.

An interdisciplinary team also worked to reduce the number of surgical site infections. These efforts have yielded improvements in antibiotic selection, dose and timing compliance. A 37 percent decrease in surgical site infections was realized during 2011.

The measure of success that embodies everything that we do is our mortality rate. In the past three years, we have been able to decrease and maintain our mortality rate at 6.6 deaths per 1000 discharges. The current national average is 12.2 per 1000 discharges. We are proud that our culture is one that 'never stops improving the quality of our patient care.

BryanLGH Medical Center Risk Adjusted Mortality per 100 Discharges

FINANCE and GROWTH: Achievements
Based upon all the improvements we've made on our Journey to Excellence, positive results are reflected in our primary service area inpatient market share.

Inpatient Market Share

COMMUNITY: Achievements
Kudos to our community's physicians.

In recognition of lung cancer awareness month and a recent New England Journal of Medicine published study brought to our attention by Dr. Rick Thompson, the newest member of our cardiothoracic surgery team, more than 660 at risk individuals received free CT screening scans at BryanLGH in November and December.

This effort, the first of its kind in our region, was made possible through the support of the physicians and staff throughout Lincoln.

This type of collaboration - where forward thinking physician champions embrace the latest clinical research and physicians across our city come together for a common goal, will position Lincoln to meet the challenges of health care reform.

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