Leaping Ahead Baystate Cited for Efforts to Improve Patient Safety

 

Citing steps that Baystate Medical Center has taken to improve patient safety, a national health care quality organization has named it one of the 50 safest hospitals in the nation.

In issuing its first-ever Top Hospitals List, the Leapfrog Group recognized hospitals that have made specific strides in areas ranging from computerized order entry to ICU staffing, all with an eye on reducing preventable medical errors and creating an atmosphere in which patients can feel safe.

“We were very gratified to be recognized as one of the safest hospitals in the country,” said Dr. Evan Benjamin, vice president of Healthcare Quality at Baystate. “It’s really a testimony to a lot of hard work.”

The Leapfrog Group is a national coalition of businesses and public agencies that promotes and rewards health care safety and quality through its collective insurance-buying power. Baystate’s recent efforts to improve on those counts are part of its participation in the Institute of Health Care Improvement’s 100,000 Lives Campaign, which highlights efforts to prevent avoidable patient injuries and deaths nationwide.

Earning Respect

Benjamin noted that the Leapfrog Group’s standards are tough. Of 1,263 hospitals that responded to the group’s survey, only 60{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} have fully implemented the recommended practices in at least one of four patient-safety categories. On the other hand, Baystate meets the goals in all four. They are:

Computerized physician order entry. Only 7{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of responding hospitals are equipped for doctors to enter patient prescriptions and other orders into computers linked to error-prevention software.

ICU physician staffing. Just 26{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of responding hospitals with intensive care units staff the units with trained ICU intensivists, and another 7{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} plan to do so sometime in 2007. Leapfrog claims that 20,000 lives may be saved annually based only on current ICU staffing upgrades.

Evidence-based hospital referral. Baystate meets Leapfrog’s specifications for five high-risk procedures and care for two high-risk neonatal conditions; a small minority of surveyed hospitals currently meet those standards in any one procedure.

The Leapfrog Safety Practices Score. This measurement assesses how hospitals handle 27 routine practices — from avoiding wrong-site surgeries to requiring a pharmacist to review all prescription orders — identified by national patient-safety organizations as key to reducing harmful errors.

The Leapfrog survey has been endorsed by national oversight groups, Benjamin noted.

For example, “instead of just talking about improving health care quality, the Leapfrog Group has been taking innovative steps to support hospitals doing it,” said Mark McClellan, administrator of the Centers for Medicare and Medicaid Services. “This shows the benefits of better information about quality of care, and is helping Americans get better care and better value.”

But it’s not a result that happens overnight, Benjamin said. “When you sit down and look at the criteria used to judge these outcomes, it’s obvious that it took a significant amount of work to get here,” he told The Healthcare News. “It’s really a journey we’ve been on for the past five years.”

Indeed, 2001 was a turning point, he explained. That was when Baystate became one of the first hospitals in the country to institute a safety reporting system whereby doctors and nurses were encouraged to openly talk about errors as a way to learn from them.

“That was a dramatic change in our culture, and in many ways has been a cornerstone of a new culture of safety,” Benjamin said. “We’ve moved away from the old strategy of keeping it to yourself, which is the model I trained with. Lawyers will tell you not to say anything, but we encourage openness and transparency when we make mistakes.”

Lives in the Balance

Officials at Leapfrog believe such culture changes are critical to saving lives and avoiding unnecessary harm. The group cites a 2004 study by Dr. John Birkmeyer at the University of Michigan claiming that, if all non-rural hospitals in the U.S. implement computer physician order entry, ICU physician staffing, and evidence-based hospital referral, more than 65,000 lives per year could be saved, and more than 907,000 serious medication errors prevented.

“Our recognition by the Leapfrog Group, combined with a number of other significant national quality awards, as well as our participation in a number of major national and statewide quality initiatives, reinforces the fact that our physicians, nurses, and the entire health care team are continuously striving to offer the highest quality patient care on a daily basis,” said Dr. Loring Flint, Baystate’s senior vice president of Medical Affairs.

Among those other quality recognitions:

• Baystate was named one of the nation’s 100 top cardiovascular hospitals by Solucient, an Illinois-based organization that studies and measures such performance at acute-care hospitals nationwide.

  “The best possible outcomes and patient satisfaction remain at the core of our efforts within our cardiovascular programs,” said Dr. John Rousou, chief of Baystate’s Cardiac Surgery Services.

• For the third straight year, Baystate’s adult medical/surgical intensive care unit received the Beacon Award from the American Association of Critical Care Nurses, which recognizes excellence in ICU nursing.

  “It’s exciting to be recognized at a national level for the excellent care we provide to our patients and their families,” said ICU nurse manager Sheila Elliott, who added that collaboration between disciplines at Baystate was key to winning the award.

• The medical center was also named a Magnet Hospital by the American Nurses Credentialing Center in 2005, recognizing excellence in nursing care. Only 3{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the nation’s hospitals have achieved this designation.
• In addition, Baystate was one of just three Massachusetts hospitals to be recognized by the National Research Corp. in its Consumer Choice Awards, through which consumers are surveyed to identify the hospitals with the highest quality and image.

“While Baystate Medical Center has received several national quality awards recently recognizing our talented and compassionate doctors, nurses, and other caregivers for their outstanding patient care, NRC’s Consumer Choice Awards is especially meaningful since it is based on measures indicative of quality from a consumer’s perspective,” said Mark R. Tolosky, president and CEO of Baystate Health.

Together, Benjamin said, the honors recognize that Baystate has made a concerted effort to improve quality of care across the board.

“Both in our leadership and with our physicians and nurses,” he asserted, “we have paid specific attention to patient safety.”