Case Studies

Two hospitals in the Kettering Health Network--Kettering Medical Center and Sycamore Medical Center-- scored among the top 3 percent of U.S. hospitals on five surgical measures collected and reported by Centers for Medicare and Medicaid Services. The hospitals have made nurses key to their improvement strategy. In addition, they have focused on national quality initiatives, such as achieving Nursing Magnet status and the Malcolm Baldrige National Quality Award. The biggest change at the two hospitals in recent years was the introduction of concurrent quality monitoring and feedback to providers and managers. The use of real-time data has inspired competition and greater accountability among physicians and nurses, resulting in near-perfect compliance with recommended surgical processes.  — View Case Study

Reid Hospital and Health Care Services is a high performer on process-of-care, or core measures. The measures, developed by the Hospital Quality Alliance HQA, relate to achievement of recommended care in four clinical areas: heart attack, heart failure, pneumonia, and surgical care. This case study focuses on Reid's achievement in providing recommended care to surgical patients in order to reduce the risk of a hospital-acquired infection.  — View Case Study

Leaders at Ridgeview attribute achievements in surgical care to the hospital's organizational culture and service line structure. Referred to as The Ridgeview Way, the hospital's systems, structures, and processes are designed to provide evidence-based care and enhancep atients experiences. The hospital also collaborates with quality improvement organizations at the state and national levels. For a small, independent organization such as Ridgeview, these partnerships provide valuable access to quality improvement resources and opportunities to work with peers.  — View Case Study

From 2004 to 2008, St Charles Hospital achieved dramatic improvement on process-of-care, or core, measures, particularly on those intended to reduce surgical complications. Conversations with administrative and clinical staff indicate that St Charles achievements in surgical care can be attributed to a hospital wide focus on quality improvement spurred by involvement in the national Surgical Care Improvement Project as well as to reliance on best-practice literature to get surgeons on board, use of preprinted order sets to standardize care processes, and a steady focus on tracking performance data and communicating results to physicians and other staff  — View Case Study

This case study focuses on Texas Health Harris Methodist-Cleburne's achievement in providing recommended treatment related to surgical care. The hospital has relied on concurrent review, changes to care processes, and preprinted order sets to improve. It also has benefited from being a part of a larger health system. In 2004, when CMS introduced the surgical measures, the hospital formed an interdisciplinary workgroup to identify opportunities for improving its performance.  — View Case Study

This case study focuses on United Hospital Center's (UHC) achievement in providing recommended treatment related to surgical care. UHC's rapid and significant improvement in this area can be attributed to hospital-wide strategies as well as policies and practices focused on the surgery department. Hospital-wide strategies include the creation of a subcommittee that reviews performance data and works across departments and disciplines to address performance gaps; careful data recording, assessment, and validation to gain the trust of physi-cians; engagement of the CEO, medical staff chairman, and medical staff; and communication of progress as well as challenges. Strategies specific to surgical care include: emphasizing best-practice literature to bring surgeons on board; providing consistent data feedback, including to individual surgeons; using peer pressure when needed; and standardizing operating room procedures through standing orders, practice sets, and checklists.  — View Case Study