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  1. Healthcare That Is Safe: The Journey to Zero
  2. Priorities for Action
  3. Core Measures and Patient Satisfaction
  4. Healing Without Harm by 2014
  5. Excellence in Obstetrics Demonstration Project
  6. "Full Disclosure" Communications with Patients and Families
  7. Centers for Medicare & Medicaid Services Partnership for Patients Hospital Engagement Network
  8. Leading Edge Advanced Practice Topics (LEAPT) Funding from CMS

Healthcare That Is Safe: The Journey to Zero. In October 2002, 110 people met in Chicago and produced Ascension Health’s Call to Action to achieve Healthcare That Works, Healthcare That Is Safe, and Healthcare That Leaves No One Behind. An 18-member Clinical Excellence team composed of Chief Medical Officers, Chief Nursing Officers and other leaders across Ascension Health convened to define the goal of Healthcare That Is Safe, and produced a road map laying out aims to guide their work. The goal statement that came out of that process was truly revolutionary: eliminating all preventable injuries and deaths in Ascension Health’s hospitals by July 2008.

"There was no system our size at that time that had committed itself to eliminating all preventable injuries and deaths. We were the first…."
—David Pryor, M.D., former Chief Medical Officer of Ascension Health and current Executive Vice President of Ascension and President and Chief Executive Officer, Ascension Clinical Holdings

Priorities for Action. In September 2003, a 39-member interdisciplinary rapid design team charged with developing a strategy to implement Healthcare That Is Safe goals recommended that Ascension Health focus on eight Priorities for Action (PFAs) to eliminate preventable injuries or deaths, as well as other goals that would drive clinical transformation. Nine Health Ministry sites were chosen to participate in a pilot. The rapid improvement across all sites exceeded expectations. Word of the pilot sites' success spread to other Health Ministries. By February 2005, more than three-quarters of Ascension Health hospitals had implemented activities related to at least five of the Priorities for Action. The original goal was to prevent 900 deaths a year. Results exceeded expectations with over 5,000 deaths avoided a year (using the expected mortality based on the Premier model) and over 1,500 lives saved using observed rates (despite an increasing case mix index or severity of illness) between 2004 and 2012.

Core Measures and Patient Satisfaction. In addition to our focus on the eight PFAs, there has been substantial work accomplished toward the improvement of core measures and patient satisfaction within Ascension Health. Systemwide performance for core measures used in Value Based Purchasing has demonstrated significant improvement. Specific tool sets and best practice approaches have been developed for each specific core measure as well as for patient satisfaction.

Healing Without Harm by 2014. Having achieved its Healthcare That is Safe goal well in advance of the July 2008 deadline, Ascension Health undertook another initiative, Healing Without Harm by 2014, which has as its goal a 40-percent reduction in serious safety events System-wide. Consistent with our efforts to foster a culture of High Reliability, and always seeking to avoid Serious Safety Events in our hospitals, Ascension Health significantly reduced its 12-month rolling Serious Safety Event Rate and likewise has reduced its observed readmissions rate. (A Serious Safety Event represents a deviation from Generally Accepted Performance Standards that reaches the patient and causes moderate to severe permanent harm or death.)

Excellence in Obstetrics Demonstration Project. Ascension Health’s participation in the Excellence in Obstetrics project was made possible through a $2.9 million grant from the Agency for Healthcare Research and Quality. More than 20,000 mothers participated at five Ascension Health demonstration sites, making this one of the largest consent-required studies for mothers nationally. Patients cared for throughout our system soon will benefit from the spread of safety-based and cost-effective interventions related to obstetric care in our hospitals.

Women who participated in the study are invited to visit the Ascension Health page that summarizes the information previously found on each of the participating Health Ministries websites.

For more information about the results of the study, please view the press release.

“Full Disclosure” Communications with Patients and Families. Communicating openly and honestly with patients and families about unexpected medical events—a practice known as “full disclosure”—improves outcomes for patients and providers.

Ascension Health adopted CORE—which stands for “Communicate Openly. Resolve Early.”—a coordinated communications and disclosure training program for physicians, nurses, and other clinical and risk management professionals. CORE is designed to empower and teach caregivers about effective ways to communicate openly and transparently with patients and their loved ones following an unexpected, adverse medical outcome.

The goals of CORE include:

  • To encourage empathy and open communication between healthcare providers and their patients
  • To advise healthcare providers concerning open communication discussions and apology, when appropriate
  • To support the continuation of the healthcare provider-patient relationship
  • To help address patient and family needs following an adverse event
  • To reduce the need for litigation by resolving issues early
  • To provide resources and care for involved providers and clinicians

For more information about Ascension Health’s “full disclosure” communications efforts, please see this news release.

Centers for Medicare & Medicaid Services Partnership for Patients Hospital Engagement Network. The Partnership for Patients is an initiative of the Centers for Medicare and Medicaid Services (CMS), which is part of the U.S. Department of Health and Human Services. Ascension Health was named one of the Partnership for Patients Hospital Engagement Networks in December 2011. The Hospital Engagement Networks have two overall goals: 1) to reduce hospital-acquired conditions by 40 percent and 2) to reduce readmissions by 20 percent, by December 2014.

The Hospital Engagement Networks seeks to accomplish these goals by concentrating on 10 Core Focus Areas: adverse drug events; catheter-associated urinary tract infections; central line-associated blood stream infections; surgical site infections; ventilator-associated events; injuries from falls and immobility; obstetrical adverse events (including early elective deliveries); pressure ulcers; venous thromboembolism; and readmissions. These 10 Core Focus Areas align closely with Ascension Health’s own Priorities for Action. As a Hospital Engagement Network, Ascension Health is a national leader in reducing early elective deliveries, falls with serious injuries, pressure ulcers and brachial plexus injuries in newborns.

Leading Edge Advanced Practice Topics (LEAPT) Funding from CMS. Only six of the 26 CMS Partnership for Patients Hospital Engagement Networks across the country are receiving advanced practice topic funds to further expand work that enhances patient safety and quality. Of these six, just two are healthcare systems. LEAPT funding was made available to Ascension Health based on our hospitals’ exceptional performance as part of our Hospital Engagement Network. With quality and safety always at the forefront of our efforts, we are allocating federal funds to support our clinical experts in identifying, developing and piloting evidence-based tools, rapidly sharing results, and spreading these interventions across our system.

For more information on interim results, click here.

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