FIRST - A Publication by the Quality and Patient Safety Division at the Massachusetts Board of Registration in Medicine, April 27, 2011

In this issue...
- "Saints Medical Center Reduces Mortality"
- "Transitions In Care at MetroWest"
- "Ambulatory Surgery Centers Initiative"  
- "First Year Anniversary QPSD"
- "Identifying Risk Factors for C-diff colitis"
- "Lessons Learned" from SQRs"
- "QPSD Notes"

Click here for the PDF>>

New England Baptist Hospital's Quality Report 2010

New England Baptist Hospital has issued a detailed report on its efforts to improve patient safety and deliver high-quality, cost-effective care. The 28-page New England Baptist Hospital Quality Report 2010 details the hospital's effort to reduce, among other items, surgical site infections, falls, and pressure ulcers, while increasing patient satisfaction scores.

From its detailed preadmission programs to its high-risk screening to prevent problems downstream in the patient's care, New England Baptist says it focuses on "prevention rather than reaction." Post surgery, the hospital focuses on postoperative delirium - a common hospital issue, but one more common in a facility where the case mix is almost entirely surgical. The Baptist also encourages its hip- and knee-replacement patients to walk as soon as possible-sometimes even the day of surgery for hip patients and the second day after surgery for knee patients. That early push to get patients out of their beds surprises many, but the Baptist says evidence shows "that patients recover more quickly if they do so."

Using easy-to-read charts detailing Reduced Length of Stay, Low Readmission Rates, Infection Control, Central Line and Ventilator Infection Prevention, and much more, New England Hospital's Quality Report 2010 shows the public in the most transparent way possible the results of its work, both in term of quality as well as value.

While all Massachusetts hospitals publicly report their outcomes, and while all strive to improve, New England Baptist has managed to tell its story in a very compelling way through its Quality Report 2010.

The report concludes by stating, "Our commitment to quality shows in what we do, not in what we say. Charts, graphs and statistics like those in this report certainly help to illustrate how we improve the patient experience at the Baptist, but they don't-can't-tell the whole story. Patient safety and quality are embedded in the very fabric of care at New England Baptist Hospital."

Treatment of Viral Respiratory Tract Infections

TO: Massachusetts Physicians
FROM: The Massachusetts Medical Society (MMS) and the Massachusetts Department of Public Health (MDPH)

Approximately 80% of adults with acute bronchitis receive a prescription for antibiotics; yet most bronchitis is due to viral infection for which antibiotic therapy offers no benefit and should be avoided.

Unnecessary use of antibiotics poses significant risk, contributing to (1) an increase in antimicrobial-resistant bacteria - a national and international health concern, and (2) side effects and adverse outcomes for patients, including the increasing and serious complication of Clostridium difficile infection.

The MMS and the MDPH are working together to provide physicians and patients with tools for treating viral upper respiratory infections without antibiotics.

The physician's and patient's mutual goal of safe and effective care is best achieved with a well-educated and informed patient population. Patients are more receptive to not receiving a prescription for antibiotics when their health care providers do the following:

- Validate their patients' concerns
- Acknowledge the discomfort caused by viral illness
- Provide specific recommendations for symptom relief

Visit www.massmed.org/antibiotics for more information and downloadable resources and to provide us with your feedback.

2010 Betsy Lehman Patient Safety Recognition Award Recipient: MetroWest Medical Center/Vanguard Health Systems

The Betsy Lehman Center is pleased to announce the 2010 recipient of the Betsy Lehman Patient Safety Recognition award and congratulates the dedicated team and leadership from MetroWest Medical Center/Vanguard Health Systems for their impressive work and success in improving care transitions for patients with congestive heart failure.

Improving Clinical Performance in Hospitals:
A Difficult Challenge for Leaders

Over the next decade, hospitals will need to make significant improvements in clinical
performance-the safety, effectiveness, and efficiency of medical care-in order to satisfy
the demands of patients, regulators, and insurers. Read complete article from the Summer 2008 Issue of Prescriptions for Excellence in Health Care>>

Healthcare Acquired Infections

Healthcare acquired infections (HAIs), also known as nosocomial infections, are infections that patients get while receiving treatment for medical or surgical conditions. HAIs occur in all settings of care, including hospitals, surgical centers, ambulatory clinics, and long-term care facilities such as nursing homes and rehabilitation facilities.

Readmissions

"Readmission" occurs when patients who have had a recent stay in the hospital go back into a hospital again. Patients may have been readmitted back to the same hospital or to a different hospital or acute care facility. They may have been readmitted for the same condition as their recent hospital stay, or for a different reason. Often referred to as "rehospitalization."

Pressure Ulcers

A pressure ulcer or bedsore is an injury to the skin or underlying tissue usually over a bony protruding area of the body. Pressure ulcers can range in severity from minor skin reddening to deep wounds. Factors that cause pressure ulcers are unrelieved pressure on the skin, or slight rubbing or friction on the skin.

Patient Falls

The National Quality Forum (NQF) defines a fall as an unplanned descent to the floor (or extension of the floor e.g., trash can or other equipment) with or without injury to the patient.

Hospitals in Pursuit of Excellence (HPOE)

HPOE provides field-tested practices, tools, education and other networking resources to accelerate performance improvement in the nation's hospitals. HPOE's fundamental principles support the Institute of Medicine's Six Aims for Improvement- care that is safe, timely, effective, efficient, equitable, and patient-centered (STEEEP).

IHI releases White Paper, Respectful Management of Serious Clinical Adverse Events, at the NAHQ Annual Meeting on Friday, October 1, 2010.

This white paper introduces an overall approach and tools designed to support two processes: the proactive preparation of a plan for managing serious clinical adverse events, and the reactive emergency response of an organization that has no such plan.
In additon to the above link, the White Paper is also included, along with other tools and resources, at http://tinyurl.com/ihieffectivecrisismgmt.

Norwood Hospital's LifeBox

BY Patrica Gavin, Norwood Hospital, Norwood, Mass.

Rooted in its mission goal of delivering quality patient care with compassion and respect, Norwood Hospital has created LifeBox as a way of preserving and transmitting information about "who a person is as a person," including the patient's wishes, values and goals. LifeBox is a collaborative effort of Norwood Hospital and 13 other health care partners.

>>Read complete article from November-December 2010 issue of Health Progress, the journal of the Catholic Health Association of the United States. Visit www.chausa.org for more information.