Healthcare consumers will hear more and more in the coming months and years about the quality of care in hospitals. Two publications issued earlier this decade, To Err Is Human (2000) and Crossing the Quality Chasm (2001) made clear to the healthcare-consuming public that hospitals need to do more than ensure that their physicians have the appropriate credentials and up-to-date facilities and technology. The publications underscored that hospitals also need to produce the quality results the public deserves. New federal pay-for-performance initiatives being established later this year provide a solid national mandate for healthcare quality.

At Community Medical Center and hospitals throughout our region and country, healthcare administrators work diligently on items such as fiscal stability, ensuring that our organizations have sufficient capital to reinvest in the aforementioned technologies and facility development. But CMC administrators and other healthcare leaders now find themselves equally consumed by solid management of clinical care delivery systems. It’s a big part of our day. It should be.

At CMC, we live by the mantra: “What gets measured gets managed.” We measure, and measure again, our performance on a variety of quality indicators, always keeping in mind our core value statement related to quality: “We aspire to the best in clinical practice, in an arena of safety, quality and transparency.”

CMC provides information about its quality of clinical care to a national database comprised of 460 hospitals of similar size. We are proud of our Calendar Year 2007 performance in several of the 126 areas we measure: Congestive heart failure average length of stay – CMC 3.45 days, Database 5.26 days; Ischemic stroke length of stay – CMC 4.48 days, Database 5.4 days; C-section per 1,000 patients – CMC 29.45, Database 31.39; Total knee average length of stay – CMC 2.84%, Database 3.53%; Total knee discharge directly to home – CMC 92.68%, Database 59.64%; Total hip average length of stay – CMC 2.54%, Database – 3.69%; Total hip discharge directly to home – CMC 89.66%, Database – 56.79%; Emergency Room length of stay more than 6 hours – CMC 2.28%, Database 10.7%; and Discharge infection rate – CMC 1.6%, Database – 3.5%.

While there is pride in this performance, CMC has several areas with room for continual improvement. CMC’s Strategic Plan for the next 18 months will prompt focus on, among other items, several issues related to quality, including communication standards for our nurses and physicians, such as the SBAR process – the Situation-Background-Assessment-Recommendation technique provides a framework for communication between members of the healthcare team about a patient's condition.

We’re establishing a transparency program, in which patient stories will be told in a variety of forums. It’s a cliché, but in hospitals, miracles happen every day. Mistakes do too; we want to relay the miracles so that we never forget the incredible business we’re in, and we want to relay the mistakes in an environment of learning. And we’ll be putting concerted focus on two Core Measures – measures established by the Centers for Medicare and Medicaid Services and the national accreditation agency for hospitals, The Joint Commission. One Core Measure we’ll be looking at is related to the treatment of pneumonia; the other is related to the national Surgical Care Improvement Project.

At Community Medical Center and other hospitals, I can tell you that performance related to quality care is a front-and-center issue. CMC’s Board of Directors has established a Quality Committee, and our engaged board members are looking not for incremental results, but for continual improvement in big ways. Our hospital leadership and our employees are being asked to generate ideas for improvement and to execute those ideas. The work is challenging and invigorating, and it is my job to ensure that we never lose sight of the fact that improving the health of our patients and making their healthcare experience safe and comforting is among the most important work in any realm.

By Jan Perry, Vice President of Patient Care Services at Community Medical Center