Case Studies In Health Care Management

Case Studies In Health Care Management-28
This report synthesizes lessons from four hospitals that reported they did not experience any central line-associated bloodstream infections in their intensive care units in 2009.Lessons include: the importance of following evidencebased protocols to prevent infection; the need for dedicated teams to oversee all central line insertions; the value of participation in statewide, national, or regional CLABSI collaboratives or initiatives; and the necessity for close monitoring of infection rates, giving feedback to staff, and applying internal and external goals.Use of the Proven Care model has improved clinical outcomes while decreasing resource utilization.

This report synthesizes lessons from four hospitals that reported they did not experience any central line-associated bloodstream infections in their intensive care units in 2009.Lessons include: the importance of following evidencebased protocols to prevent infection; the need for dedicated teams to oversee all central line insertions; the value of participation in statewide, national, or regional CLABSI collaboratives or initiatives; and the necessity for close monitoring of infection rates, giving feedback to staff, and applying internal and external goals.

As part of their efforts to improve care, the intensivists recommended use of an evidence-based CLABSI prevention protocol that includes the use of a checklist to promote compliance.

To ensure the protocol was followed, the hospital trained and empowered nurses to enforce standards during the placement process and restricted the number and type of hospital personnel permitted to insert lines.

Key factors driving Health Partners' performance are a consumer-focused mission; a regional focus, scale, and scope integrating a broad range of services; strategic use of electronic health records to support care redesign; and a culture of continuous improvement.

A comprehensive model for improvement includes setting ambitious targets for health system transformation; measuring what is important in order to optimize care; agreeing on best care practices and supporting improvement at the clinic level; aligning incentives with goals; and making results transparent internally and externally.

Fairview Southdale Hospital was recognized as one of 13 "Highest Value Hospitals" by the Leapfrog Group in 2008, based on efficiency scores that took into account quality of care as well as resource utilization.

The hospital, which was selected from nearly 1,300 hospitals that had voluntarily submitted data, received a top efficiency score for all four conditions/procedures examined: coronary artery bypass graft, percutaneous coronary interventions, treatment of acute myocardial infarction, and pneumonia care.The report also presents ways these hospitals are spreading prevention techniques to non-ICU units, and strategies for preventing other health care-associated infections.This nonprofit teaching hospital relies on intensivists to provide ICU caare.Since 2002, the hospital has followed three strategies to improve patient satisfaction: allocating significant new funding for quality measurement and process improvement work, including establishing a Center for Clinical Excellence; developing a management information system for hospital leaders that tracks patient and family experiences, along with other hospital performance indicators; and seeking to enhance patients' experiences by working with frontline staff, including implementing new recruitment, training, management, and improvement strategies.This private hospital has a designated team, known as the Vascular Access Specialist Team, comprising about 10 registered nurses who have a minimum of two years of nursing experience and are specially trained in central line insertion techniques, ultrasound guidance, and Centers for Disease Control and Preventioninfection prevention guidelines.Health Partners' experience suggests that a nonprofit health plan market oriented to physician group practice--supported by collaborative measurement, improvement, and reporting structures--creates a community environment that helps each participant achieve objectives more effectively.Henry Ford Health System is a vertically integrated health care system in southeastern Michigan whose leadership is committed to systemic integration, clinical excellence, and customer value through the core competencies of collaboration, care coordination, and innovation and learning.Carolinas Medical Center was established by the Charlotte-Mecklenberg County Public Authority in 1939 to meet the health care needs of Mecklenberg County residents, and opened its first hospital in 1940.Keeping pace with population growth, multiple facilities now continue the original mission to "care for all who come." High scores on process-of-care, or "core," measures distinguish the Carolinas Medical Center network hospitals as a group, and Carolinas Medical Center–University as the top performer among them.Geisinger's leaders believe that the organization can simultaneously improve quality, satisfaction, and efficiency only by redesigning and reengineering the delivery of care.This philosophy is epitomized by Proven Care, a portfolio of products (many of which are package-priced) for which care processes have been redesigned to reliably administer a coordinated bundle of evidence-based best practices.

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