Inside a Leapfrog Group Top-Ranked Hospital
In addition the medical center fully meets Leapfrog surgical quality and cost standards in seven of nine treatments, including heart bypass surgery and pancreatic resection. It has made substantial progress to meet the standards for aortic valve replacement and heart attack treatments.
In an e-mail exchange, Gary Kaplan, MD, chair and CEO of Virginia Mason, explained that its focus on Leapfrog indicators began about 10 years ago, when The Boeing Company became the lead employer for The Leapfrog Group's roll-out in the Puget Sound region.
The medical center was already looking at new management models to help improve its healthcare delivery system and improve quality. Boeing used the Toyota production system, which and Kaplan and his team adapted to healthcare.
Similar to the Toyota system, the Virginia Mason production system is based on eliminating waste—anything not having value as defined by the customer. "We realized that our systems weren't designed for the safety and convenience of our customer, the patient, but based on the preferences of our providers, managers, and technicians and those of us working in healthcare," explained Kaplan.
He added that "the Leapfrog Group became an early priority because its measures provided tangible evidence of both performance and improvement over time, and because the pillars of the Virginia Mason production system and The Leapfrog Group are complementary."
In a November 2011 speech before the U.S. Senate's Committee on Health, Education, Labor and Pensions, Kaplan noted several organizational and departmental improvements since implementing the VMPS, including:
- Saving $11 million in planned capital investment by using space more efficiently.
- Reducing inventory costs by $2 million through supply chain expense reduction and standardization efforts.
- Reducing labor expense in overtime and temporary labor by $500,000 in one year.
- Reducing professional liability insurance 59% from 2004 to 2010.
- Improving medication distribution from physician order to availability for administration from 2.5 hours to 10 minutes, and reducing incomplete inpatient medication orders from 20% to 40% to less than 0.2% through process improvement and CPOE implementation.
In 2010 The Leapfrog Group recognized Virginia Mason and the University of Maryland Medical Center as The Leapfrog Group's "Top Hospitals of the Decade" in recognition of their achievements in reducing medical errors and their innovations in patient safety and quality.
The Leapfrog hospital survey is adjusted each year to reflect new research about quality, safety, and efficiency measures. The 2011 survey added a section on the patient experience. Changes under consideration for the 2012 survey include the removing hospital-acquired pressure ulcers and injuries measurements and expanding the list of ICUs for which hospitals will be asked to report their rates of central line associated bloodstream infections.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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