Each year through its Achievement Awards program, The Hospital & Healthsystem Association of Pennsylvania (HAP) recognizes hospitals and health systems that enhance and refine health care quality, delivery and cost effectiveness. Chester County Hospital received two of the 15 HAP awards out of a total of 100 other entrants in five categories. It earned awards in the categories for Patient Safety and Operational Excellence.
According to HAP, "Pennsylvania hospitals are doing their part to inspire, innovate, and create. Many are discovering ways to engage the community in wellness initiatives, improve technologies to better serve patients and reduce costs, and enhance the way patients are cared for and treated. HAP knows that many hospitals are working toward better health care in the state, and the Achievement Awards offer a way to recognize several of these outstanding efforts."
At a recent meeting of the hospital's senior leadership, Mike Suchanick, HAP's Chief Operating Officer, presented the awards, saying, "I'm so pleased to be able to present your hardworking teams with two awards that represent Chester County Hospital's strength, teamwork and innovation. HAP appreciates all the hard work and research that was dedicated to these winning programs, as your innovation affects your community's health and helps drive Pennsylvania's health care delivery system forward."
PATIENT SAFETY - Entry title: "Reducing Falls: From the Patient's Perspective"
The Patient Safety award category acknowledges projects that take steps to support an accountable and safe health care organization.
The hospital's Quality Department created a Patient Assisted Incident Reporting (PAIR) program, introduced a "falls interview" document, and increased falls education and reporting for its nursing department. Implementation began with interviews of patients who had sustained a fall not resulting in serious injury. Some of the questions included were:
- What were you doing when the fall occurred?
- Why do you think the event happened?
- Do you think this event could have been prevented and how?
The evidence of sustained improvements from the PAIR interview document is significant. From 2012 to 2013, the hospital's falls rate decreased by 16% and serious injury from a fall decreased by 50%. Furthermore, the team looked at the data trends for medications, such as narcotics and sleep aids, in falls patients. Because of the initiative, Ambien dosage decreased from 10 mg to 5 mg and was removed from the automated Comfort Care order set. Finally, the team started a bedside handoff practice in which the conversation of fall risks and hourly rounding took place.
OPERATIONAL EXCELLENCE - Entry title: "Physician Direct Queuing: Re-Engineered ED Patient Care Delivery Model"
The Operational Excellence category looks for entrants to improve the patient experience and strengthen operations and hospital efficiency.
Emergency Department (ED) leadership addressed the issues of ED crowding, extended lengths of stay, lower-than-expected patient satisfaction scores, left-without-being-seen volumes, and the difficulty of the ED to respond to high patient volumes while maintaining patient-centered care.
To address these concerns, a Rapid Treatment Area (RTA) model and new ED patient-care flow process were established. New equipment was purchased to reduce times and increase performance capabilities. A split-flow process designated patients as "vertical" -- not needing to occupy a bed, and "horizontal" -- needing a bed due to clinical conditions or treatment plans. An internal waiting room, staffed by an ED Registered Nurse, was added. The patient registration practices changed to a mini-version at arrival and the full process at the bedside or when waiting for test results.
As a result, there has been a 78% reduction in time for walk-in patients to be seen by a provider, a 50% reduction in length of stay for RTA patients, a 32% reduction in length of stay for all ED patients. Finally, the RTA flow reduced the number of left-without-being-seen patients by 82%.