Hospitals today are pressured more than ever to maintain high levels of clinical care and patient safety — a responsibility that has only been heightened with the passing of healthcare reform. McLeod Health in Florence, S.C., took an innovative approach to ensuring their quality of care more than ten years ago by creating a physician-led, evidence-based initiative called "Clinical Effectiveness," which aims to improve patient care by having a team of physicians meet and review medical literature to test best clinical practices in caring for patients. Staff members from McLeod, which won the American Hospital Association McKesson Quest for Quality Prize in July 2010, discuss six practices that can help a hospital continually improve its quality of care.
1. Establish urgency. Donna Isgett, senior vice president for quality and safety, says creating a sense of urgency that is driven by data has been fundamental in getting physicians and other hospital employees engaged.
"We know you're not going to get anybody to work on something if there's no sense of urgency," Ms. Isgett says. "If you show physicians that complication rates at your hospital are twice as high as [competing hospitals], you create urgency."
2. Seek support from top executives and the hospital board. Steve Ross, MD, has worked at McLeod since 1983 and led the Clinical Effectiveness program as medical director for five years. Dr. Ross says the program could not have happened without the support of the hospital's board of trustees.
"The governing body has to be committed to quality. They have to be committed to providing resources, funding, information technology staff, nurses and people that do work behind the scenes [to provide physicians extra support]," he says.
3. Create a team atmosphere. Alan Blaker, MD, FACC, who also served as the first medical director of the Clinical Effectiveness program from 1998 to 2002, says the hospital's culture began to change to a more team-based one once more staff members started getting involved in the program.
"[The physicians] like the fact that it was a physician-led, evidence-based effort at changing the system. It's not someone coming to them and telling them what to do," Dr. Blaker says. "Nurses wanted to help because [getting involved] would eventually make their job easier [by providing consistency to care], and they learn from the medical literature and discussions with medical staff."
4. Ensure the physicians have support. Physicians have their days filled with ongoing responsibilities to patients, other staff members and administration, which can cut into the quality of care provided to patients. Ensuring physicians receive backend support and respecting their time help alleviate some of their responsibilities, ensuring quality of care is never compromised.
"One of the things that has enabled our physicians to be involved effectively is the physicians don't have to do the [support] work or work behind the scenes," Dr. Ross says."
5. Reward staff members as an added incentive. Dr. Ross says that, although physicians are intrinsically motivated to study best clinical practices, recognition is important as well. McLeod's administration often recognizes its staff members with letters, public acknowledgment and gift certificates to restaurants to reward them for their volunteer work with the Clinical Effectiveness program.
6. Constantly review medical literature. As part of the Clinical Effectiveness program, physicians review medical literature and come to an expert conclusion on how to best care for patients with various conditions. Although the staff has jointly made numerous conclusions, they make sure the literature is reviewed constantly for new medical updates to guarantee best practices.
"Even with [focusing on best practices for treating pneumonia], which we started in 1998, we have cut our mortality by two-thirds," Dr. Ross says. "But we still meet every six months to review antibiotic susceptibilities, and we've been doing that now for more than ten years."
Learn more about McLeod Hospital.
1. Establish urgency. Donna Isgett, senior vice president for quality and safety, says creating a sense of urgency that is driven by data has been fundamental in getting physicians and other hospital employees engaged.
"We know you're not going to get anybody to work on something if there's no sense of urgency," Ms. Isgett says. "If you show physicians that complication rates at your hospital are twice as high as [competing hospitals], you create urgency."
2. Seek support from top executives and the hospital board. Steve Ross, MD, has worked at McLeod since 1983 and led the Clinical Effectiveness program as medical director for five years. Dr. Ross says the program could not have happened without the support of the hospital's board of trustees.
"The governing body has to be committed to quality. They have to be committed to providing resources, funding, information technology staff, nurses and people that do work behind the scenes [to provide physicians extra support]," he says.
3. Create a team atmosphere. Alan Blaker, MD, FACC, who also served as the first medical director of the Clinical Effectiveness program from 1998 to 2002, says the hospital's culture began to change to a more team-based one once more staff members started getting involved in the program.
"[The physicians] like the fact that it was a physician-led, evidence-based effort at changing the system. It's not someone coming to them and telling them what to do," Dr. Blaker says. "Nurses wanted to help because [getting involved] would eventually make their job easier [by providing consistency to care], and they learn from the medical literature and discussions with medical staff."
4. Ensure the physicians have support. Physicians have their days filled with ongoing responsibilities to patients, other staff members and administration, which can cut into the quality of care provided to patients. Ensuring physicians receive backend support and respecting their time help alleviate some of their responsibilities, ensuring quality of care is never compromised.
"One of the things that has enabled our physicians to be involved effectively is the physicians don't have to do the [support] work or work behind the scenes," Dr. Ross says."
5. Reward staff members as an added incentive. Dr. Ross says that, although physicians are intrinsically motivated to study best clinical practices, recognition is important as well. McLeod's administration often recognizes its staff members with letters, public acknowledgment and gift certificates to restaurants to reward them for their volunteer work with the Clinical Effectiveness program.
6. Constantly review medical literature. As part of the Clinical Effectiveness program, physicians review medical literature and come to an expert conclusion on how to best care for patients with various conditions. Although the staff has jointly made numerous conclusions, they make sure the literature is reviewed constantly for new medical updates to guarantee best practices.
"Even with [focusing on best practices for treating pneumonia], which we started in 1998, we have cut our mortality by two-thirds," Dr. Ross says. "But we still meet every six months to review antibiotic susceptibilities, and we've been doing that now for more than ten years."
Learn more about McLeod Hospital.