“All of our data is very transparent. We show it to staff, to our physicians, and we post our outcomes on our website for infection rates and core measures and standards. That transparency not only helps people be accountable, but it shows our progress and our level of excellence. The accountability is key,” says Wheelan.
The Our Lady of Resurrection Medical Center approach
Having fared statistically not so well on readmissions in the past, Our Lady of Resurrection Medical Center, part of a Chicago-based six-hospital system, took improvement very seriously. David A. DiLoreto, MD, chief medical officer, says OLRMC decided to approach the problem with itself first, developing a common set of protocols to help address rehospitalization rates. OLRMC found its readmissions particularly challenging due to a high percentage of non-English-speaking patients who had access to Medicare Part A inpatient coverage, but not Medicare Part B to help with outpatient care.
More than a year ago, OLRMC began to address readmission by using cardiac rehabilitation nurses to work with patients prior to discharge. A specific nurse was assigned to each patient and each would work with the patient to educate him or her on what needed to occur after discharge and would follow up within 48 hours. If the patient didn’t have the correct insurance to cover a visit to a specific doctor, the nurse would ensure that the patient was sent to a federal clinic.
“We got our medical staff involved in establishing some best clinical practices for these patients,” says DiLoreto. “That includes standard order sets, standard best practices, and increasing the use of some of our home health services.”
The new protocols are working, too, says DiLoreto; of the six hospitals in the system, OLRMC went from being the worst performing in terms of cardiac readmission to the best, decreasing its rates by 50%. Now the system is rolling out these protocols to the rest of its hospitals.