Abstract W P279: A Multi-Campus Health System's Approach to Achieving the Highest Level of Quality Through Standardization of Practices
Background: With healthcare reform, non-value added variation will be difficult to maintain while remaining a financially successful healthcare institution under new legislation. Our organization began looking at the highest levels of quality throughout our 5 campus system, and standardizing practice in order to achieve the same high quality standards across all sites.
Methods: Acute ischemic stroke (AIS) accounts for approximately 85% of the all stroke patients; therefore, we prioritized establishing structure around AIS patients first, in order to achieve greatest impact. The first piece of the structure developed was the Preformatted Order (PFO). It is completed by the healthcare provider and a large driver in the consumption of healthcare. It was decided by setting the ‘structure’ or PFO at the point of admission could dramatically impact the care provided throughout the hospitalization. Each hospital had an individualized PFO for ED Stroke Code, IV tPA Administration, Admission Order for patients receiving IV tPA, and Admission Orders for patients with AIS/TIA without IV tPA. All were independently built with the AHA’s Clinical Practice Guidelines but site specific variation persisted. Best practices and data were analyzed from each campus to identify elements for a system PFO in each of the above. Quality and CPGs remained the driver for decision making while PFOs were built. Once agreed upon by medical staff, the system-wide PFOs were rolled out across all sites.
Results: Significant improvements in dashboard metrics were identified when compared with the prior year’s data (same timeframe). The most significant, was a reduction of 0.9 days in the patient’s average length of stay (ALOS), when examined year-over-year. (FY12Q3 ALOS 4.73 days, FY13Q3 ALOS 3.80 days). The campus with the highest cost and longest ALOS, was able to demonstrate a reduction of 1.76 days in the patient’s ALOS, examined year-over-year. (FY12Q3 ALOS 5.04 days, FY13Q3 ALOS 3.28 days).
Conclusions: Developing a structure aiming at the highest quality can result in an overall cost reduction and decreased ALOS. This structure will allow us to retain the same high level of care across all hospital sites, while allowing for customization of care, tailored to specific patient needs.
Author Disclosures: K. Clarkson- Afshar: None. R. Richetts: None. L. Olson-Mack: None. C. Bajkiewicz: None. L. Berger: None.
- © 2014 by American Heart Association, Inc.