Straight Talk - "Continued focus on quality"

March 20, 2014

Dear Friends and Colleagues,

It wasn’t that long ago that NCH was attending conferences learning from other hospitals about their “best practices.” Today, we’re doing much of the teaching—especially when it comes to “quality.” That was the case this month in Tallahassee when NCH, along with 18 healthcare systems from around Florida, demonstrated our best practices as part of the 2014 Florida Hospital Association (FHA) hospital days.

Associate Chief Nursing Officer Jon Kling shared NCH’s impressive project to reduce sepsis (blood stream infections). Led by Dr. Doug Harrington, RN Jen Ringle, Dr. Alberto DeLaRivaherrera, Dr. Jeff Panazzo, RN Maureen Powers, RN Betsy Novakovich and our Critical Care Coordinators, we statistically saved 172 lives and avoided some $3.7 million in costs in 2013.

The death rate from sepsis nationally ranges from 20%-50%. NCH’s rate dropped from more than 30% before we instituted an early identification “chart alert” to the mid-teens after adopting our Cerner partner’s excellent electronic medical record, which alerts physicians, nurse practitioners, physician assistants, and nurses in the ER and ICU of impending deterioration.

Other posters from colleague Florida healthcare systems were equally impressive, with projects ranging across fall prevention, readmission avoidance, and having babies not delivered prematurely. Many of these initiatives grew out of the FHA’s Hospital Engagement Network (HEN), which started over a year ago with the goal of reducing harm by 40% and readmissions by 20% ; we have made good progress. Florida’s HEN is part of the American Hospital Association’s HEN, which includes 34 states and 1,800 hospitals. There are also seven other HENs in Florida all sponsored by reputable organizations with similar goals. That’s the good news.

The bad news is that unfortunately, less than half of Florida’s hospitals participate in any of the HENs. And that’s a shame. Learning “best practices” allows us opportunities to gain the trust of citizens we currently serve and those considering coming to Florida. We focus on quality improvement, share best practices among us, encourage other healthcare systems to participate, standardize metrics, simplify data collection, and reward those colleagues who are models for all of us. The system works, and more hospitals should use it.

Florida is currently ranked 33rd ( among all states in terms of health by United Health. That’s an improvement over recent years, thanks largely to the efforts of the FHA. Under the leadership of FHA’s CEO Bruce Rueben, Kim Streit, Martha DeCastro, RN and the entire Patient Safety and Quality Committee, we have moved from the fourth quartile to the third over the past five years. We have aspirations to move into the 2nd quartile as a state within the next five years. But to get there, we will need many more of Florida’s eligible hospitals which provide acute care to participate. Florida has over 300 hospitals with about 100 focused on rehabilitation, long-term acute care, psychiatry or other non-acute care issues.

Last week Florida Gov. Rick Scott met with the FHA Board, of which I am currently Treasurer and Chair of the Quality Committee. The Governor enthusiastically volunteered to help FHA reward best practices and encourage more systems to participate. Healthcare in our state and our nation must continue to focus on quality, as opposed to adversarial politics or financial gain. Helping our elected officials at all levels understand the importance of working together to help all people live longer, happier, and healthier lives is a goal with which everyone, regardless of political affiliation, should agree.


Allen S. Weiss, M.D., President and CEO

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