Halvor­son’s let­ters to em­ploy­ees cel­e­brate suc­cesses

Modern Healthcare - - NEWS -

Over the past five years, Kaiser Per­ma­nente Chair­man and CEO Ge­orge Halvor­son, who will re­tire at the end of this year, sent a weekly let­ter to the 180,000 peo­ple who work for the na­tion’s largest in­te­grated health­care de­liv­ery sys­tem. Ev­ery let­ter cel­e­brated a par­tic­u­lar success within the or­ga­ni­za­tion. The let­ters usu­ally fo­cused on care de­liv­ery. They have now been com­piled in a book, KP In­side: 101 let­ters to the peo­ple of Kaiser Per­ma­nente. Here are ex­cerpts from three:

Cel­e­brat­ing our sep­sis mor­tal­ity re­duc­tion suc­cesses Nov. 18, 2011

Dear KP col­leagues, Sep­sis kills. Sep­sis is ac­tu­ally the No. 1 cause of death in hos­pi­tals in Cal­i­for­nia.

Ac­cord­ing to the of­fi­cial state death-rate statis­tics, more peo­ple die in hos­pi­tals from sep­sis than die from can­cer, stroke or heart disease.

State statis­tics tell us that 24% of se­niors who die in Cal­i­for­nia hos­pi­tals—nearly one in four se­niors—die from sep­sis.

Very few peo­ple know that to be true. Very few peo­ple are do­ing any­thing about it.

Our goal is to have the safest hos­pi­tals in Amer­ica, so we are an ex­cep­tion to that rule. We are do­ing some­thing about sep­sis—and what we are do­ing is work­ing.

When we started mea­sur­ing the per­cent­age of our sep­sis pa­tients who did not sur­vive, our first mor­tal­ity num­bers were sig­nif­i­cantly more than 20%. One in four sep­sis pa­tients did not sur­vive.

Now we have made con­sis­tent im­prove­ments in ev­ery hospi­tal and our death rate has dropped to 11%.

That is half as many peo­ple pass­ing on. How did we save all of those lives?

We had very smart peo­ple fo­cus on the prob­lem to fig­ure out what we needed to do to make care bet­ter for sep­sis pa­tients.

It turns out that speed is es­sen­tial. There is a time called the “golden hour” at the be­gin­ning of treat­ment for each pa­tient where rapid in­ter­ven­tion with the right treat­ment really is golden.

De­layed care can be fa­tal. Fast care can work mir­a­cles.

So we fig­ured out how to di­ag­nose quickly, pre-plan ev­ery re­sponse, pre­de­fine the right med­i­ca­tions and train peo­ple in our care sites to re­spond in a hurry with the right stuff in the right way.

We did not sur­ren­der to sep­sis. We did not say—“Sep­sis hap­pens and that’s too bad.”

In­stead, we said—“Sep­sis hap­pens—let’s save a lot of lives by re­spond­ing really, really well to pro­vide the right care to ev­ery pa­tient.” That’s the right an­swer. So my let­ter this week cel­e­brates the bril­liant teams of KP folks who fig­ured out how to save all of those lives—and all of the care­giver teams who are get­ting bet­ter at sav­ing lives ev­ery day.

Con­tin­u­ous im­prove­ment is a won­der­ful thing.

Well done. Be well. Ge­orge

Cel­e­brat­ing our pres­sure ul­cer preven­tion pro­gram Dec. 17, 2010

Dear KP col­leagues, Pres­sure ul­cers can eat through the skin and mus­cle of a pa­tient and cre­ate a wound that is all the way to the bone.

Pres­sure ul­cers can dis­fig­ure pa­tients, some­times for­ever. Af­ter ul­cers heal, plas­tic sur­geons of­ten have to re­pair the dam­age caused by the ul­cer in its de­struc­tive stages.

Pres­sure ul­cers can kill—and it can be a very painful way to die.

Pres­sure ul­cers have been a ma­jor curse of hospi­tal care­givers for as long as hos­pi­tals have ex­isted. Ev­ery hospi­tal has its truly sad sto­ries about pa­tients whose lives were ru­ined and ended by pres­sure ul­cers.

Why am I writ­ing about pres­sure ul­cers and the mis­ery they cause in my weekly let­ter?

We re­cently had our an­nual Dr. David Lawrence Pa­tient Safety Award cer­e­mony (named for the former CEO of Kaiser Foun­da­tion Health Plan and Hos­pi­tals). Ev­ery year, we cel­e­brate a re­gion that has done an ex­cep­tional job on pa­tient safety.

This year’s win­ner was North­ern Cal­i­for­nia, for putting in place a pres­sure ul­cer preven­tion pro­gram so ef­fec­tive that two of our hos­pi­tals went two full years with­out a sin­gle re­portable Stage 3 or greater pres­sure ul­cer. Zero is an amaz­ing num­ber. Zero takes an in­cred­i­ble con­sis­tency of car­ing for each pa­tient. Zero is the re­sult of care so good it de­serves to be called deeply com­pas­sion­ate care—treat­ing each pa­tient like fam­ily—tak­ing the pa­tients’ best in­ter­ests so much to heart that ev­ery sin­gle pa­tient gets the care they need to make sure those ul­cers don’t hap­pen.

Prevent­ing pres­sure ul­cers is a won­der­ful thing to do. The pa­tients who never get a Stage 3 or higher ul­cer don’t know how ex­tremely lucky they are to be get­ting their care from us—be­cause we care enough to make sure those ul­cers don’t hap­pen.

Con­grat­u­la­tions. Well done. Be well. Ge­orge

Cel­e­brat­ing the 2011 David Lawrence Pa­tient Safety Awards Jan. 6, 2012

Dear KP col­leagues, One pro­gram cut the num­ber of pres­sure ul­cers in a hospi­tal to zero for nearly a year.

An­other pro­gram cut the num­ber of med­i­ca­tion er­rors by more than half.

An­other pro­gram helped high-risk pa­tients in times of tran­si­tions from care site to care site.

An­other pro­gram re­duced the in­crease, abuse and risk of Oxy­Con­tin use.

Yet an­other pro­gram cre­ated rapidresponse teams that achieved a 47% re­duc­tion in pa­tients need­ing “code” level of care.

An­other pro­gram set up ex­ten­sive train­ing pro­grams us­ing man­nequins and com­put­er­ized pa­tients to im­prove team care and pa­tient re­sponse tech­niques and ap­proaches.

An­other pro­gram de­creased ther­a­peu­tic mis­use of ac­etaminophen.

What do all of those pro­grams have in com­mon?

They are all Kaiser Per­ma­nente pro­grams that have been nom­i­nated for the Dr. David Lawrence Pa­tient Safety Award.

My let­ter this week cel­e­brates the Kaiser Per­ma­nente pa­tient-safety pro­grams that were so dis­tinc­tive and well done that they earned Lawrence Award recog­ni­tion. Well done

Ge­orge

Ge­orge Halvor­son is Chair­man and CEO of

Kaiser Per­ma­nente

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