A bumpy quality journey
Since Dr. Eden Takhsh took the role of chief quality officer in 2013, Saint Anthony Hospital’s quality-improvement journey has had big hits and continued misses.
The hospital has concentrated on hardwiring clinical processes to achieve better outcomes for patients, with some measures showing significant improvement while others still remain below average. It has a two-star rating on Hospital Compare and struggles with high readmission rates, low patient experience scores and poor timeliness of care outcomes, according to the site.
“There are areas that have been a struggle for us,” Takhsh said. “We have a ways to go but we are working on it.”
The Hospital Compare rating reflects data from 2016 to March 2017, which Saint Anthony leaders are quick to point out is dated, noting that they’ve made improvements since then. For instance, its hospital-wide 30-day readmission rate is currently at 8%, while in June 2016 it was the same as the national rate of about 15.3%, according to Hospital Compare.
Improving patient experience scores remains a challenge for Saint Anthony, Takhsh said. It currently has a one-star rating for its survey scores on Hospital Compare. The hospital has a lower-than-average response rate on the patient satisfaction survey. Further, its survey scores are deducted on Hospital Compare because many respondents don’t speak English as their first language or have a low level of education. The CMS dings hospital scores for such reasons because it’s thought the respondents could struggle to understand the questions.
These deductions are frustrating to Guy Medaglia, CEO of Saint Anthony.
“I have been to Washington several times presenting the concerns over this,” he said. “One size doesn’t fit all.”
Despite its struggles on some measures, Saint Anthony has been excellent at controlling infections, which reflects its ongoing effort to improve quality. For the past five years, the hospital has reported just one case each of a central line-associated bloodstream infection and a catheter-associated urinary tract infection.
Saint Anthony points to its hospitalwide huddle initiative as a reason why it has been able to achieve the outcomes.
Each day, all of the physician and nurse leaders on each of the units across the hospital along with Takhsh and other administrative leaders meet at 8 a.m. for about 15 minutes to go over any patientsafety concerns within the previous 24 hours. Additionally, all Foley and urinary catheters in place are reviewed to discuss if and when they should be removed from the patient.
“It has eliminated so many communication barriers. What we can achieve in 15 minutes would take several emails back and forth,” Takhsh said in an interview with Modern Healthcare earlier this year.