The Department of Health and Human Services believes that best practices, techniques and solutions for obtaining higher levels of quality and safety among hospitals should spread, um, well…like a disease.
Those are my words, not theirs, but allow me to continue with my bad ironic similes and consider that the $218 million the agency is investing in so-called "Hospital Engagement Networks" as Typhoid Mary.
The money, distributed among 26 organizations, will help identify and teach other hospitals and healthcare providers the solutions that have been already proven to reduce healthcare acquired conditions.
As part of the public-private Partnership for Patients program, the agency will distribute that money among 26 state, regional, or nationwide hospital organizations to be invested in the infrastructure to help train their colleagues on best practices.
According to HHS, the recipients will "conduct intensive training programs to teach and support hospitals in making patient care safer, provide technical assistance to hospitals so that hospitals can achieve quality measurement goals, and establish and implement a system to track and monitor hospital progress in meeting quality improvement goals."
That's a mouthful, but it represents accountability for results.
Some of the recipients are actual hospitals and health systems, others are state, local and national hospital associations.
Ascension Health, the largest Catholic health system in the country with hospitals in 21 states, is getting $8.4 million of the total, to be spent over the three-year life of the program on staffing for meetings, providing the educational materials and remote meeting infrastructure, and providing follow-up care provider support, says Ann Hendrich, vice president of clinical excellence operations for Ascension in St. Louis. Hendrich is heading up the initiative at Ascension.
"A big role that we'll play is how we package and produce our material so that we can bring other hospitals and systems to the same level of performance," says Hendrich, a registered nurse by training.
Ascension will use the funds to update some of the content they've already produced for consumption within the health system for a broader audience in seven of the 10 focus areas identified by the scope of the project.
In the other three areas, Ascension's healthcare professionals and executives can be expected to be among the learners. In any case, they'll participate heavily in all of them.
Infrastructure will be another relatively big spending target for the funds.
"There's significant investment in expanding the technology that supports having this many calls online in a coordinated way," she says. "We'll use our network within Ascension but we could be inviting others into our clinical meetings and we're also packaging our material for the content provider."
Why Ascension? Well, compared to the national averages, it has achieved 25% lower mortality overall, 65% fewer birth traumas, 89% lower neonatal mortality rates, not to mention 94% lower in hospital-acquired pressure ulcers, 74% lower in ventilator-associated pneumonia and 43% lower in central-line blood stream infections.
But Hendrich is focusing not on Ascension's achievements, but rather on the program's offerings, which are rolling out pretty much immediately. Transferring the lessons has all her attention. When I spoke with her a couple of weeks ago, she was already putting the finishing touches on an in-depth program that Ascension will teach in partnership with Intermountain Healthcare on obstetrics—specifically ways to limit birth trauma.
"Part of the role we're being asked to play is to help other healthcare systems understand and adapt the transformation process we've already used in practice," she says.
That's a fancy way of saying that what they do is working, and they want to share it.
The money from the Hospital Engagement Network initiative does not start or stop the work on quality and safety at Ascension, Hendrich is careful to point out. But she's excited because of the quick wins and fast learning that can occur when systems see what has already worked for others in quality and safety improvement.
"This allows us to benefit from the learning of many but also to share our learning with other systems who may be struggling," she says. "One of the characteristics of high-reliability organizations is their deference to expertise. We're not too proud to say we can't always learn from someone else."
Not all the learning will come from big systems to small ones, as you might imagine, given the size of many organizations on the recipient list.
Within Ascension, she notes, sometimes the smaller organizations outperform the larger ones.
"It's not about the size of the organization, but about the processes and how people, processes and technologies react," she says. "I'm not going into this assuming it will always be the large system showing the way."
So what's keeping this exercise from being another wasteful government grant? After all, it's debatable whether a lot of this work would have to happen regardless, given the increasing link between quality of care and outcomes with payment for healthcare services.
"We are not adding any significant overhead to do this work," says Hendrich. "We must do it anyway. The funding supports the dissemination, production and measurement, which a key aspect of this project because what we'll be reporting and collecting requires some more effort."
So without the grant, such activities certainly wouldn't be shared widely or in any kind of formalized training program. At worst, without money to pay for infrastructure and time, some of these techniques for providing better patient care could even been seen as trade secrets—a way to maintain your competitive advantage. All right, maybe that's going too far. But allowing the lessons to percolate organically takes too much time, and in this situation, time lost equals lives lost.
While it's not a true ROI measure, and they're not taking the money back if it's not achieved, HHS goals for the program are bold: a 40% reduction in healthcare-acquired conditions and a 20% reduction in hospital readmissions for participants.
If they can achieve those kinds of results, nobody's going to be asking whether the grant was well spent. They'll want to expand it.
Philip Betbeze is the senior leadership editor at HealthLeaders.