The Tuality Healthcare Cardiac Services team recently received the American Heart Association’s Mission Lifeline Gold Plus Award and the Joint Commission’s Chest Pain Certification. Both of these reflect the team’s commitment to process and systematic improvements as critical to providing excellent patient care. The two awards involved the Cardiac Services team, but also numerous departments including Cardiac Rehabilitation, the Emergency Department, Community Education, Intensive Care Unit and Progressive Care Unit to name a few.
The team received The American Heart Association Gold Plus Award for developing a new order set for physicians to use for coronary syndrome patients. The new order set offers physicians an algorithm they can use to monitor and track their patient’s medications. This new order set also addresses all of the medication subsets set forth by the American College of Cardiology’s for incoming and discharged patients. The Gold Plus Award is awarded to facilities based on their accreditation and data-submission efforts. Hospitals also have to be submitting for eight consecutive quarters with a certain score in their care to qualify. “The plus portion of the Gold Plus Award is if you have a transferring facility, which is Forest Grove Hospital to us. We were able to exceed that status so we went from silver status the first year to gold plus the second year,” said Brody Ferguson, Tuality’s Director of Cardio/Pulmonary Services.
The Joint Commission’s Chest Pain Certification involved two years of data collection, order set modifications, physician and staff education, and executive approval. The data collected focused specifically on Acute Coronary Syndrome patients who have experienced a heart attack or are hospitalized with a diagnosis of coronary artery disease. The data looked at five metrics from when the patient enters the hospital to when they are discharged.
“Did the patient get aspirin within 24 hours, did they get an EKG (electrocardiogram) within 10 minutes, on discharge were they eligible for cardiac rehab, or was smoking cessation made available to the patient,” said Patricia Gilbert who serves as the Cardiac Clinical Improvement Coordinator for Tuality Healthcare.
The clinic’s efforts to progress in these areas improved overall “deficit-free care” by 56 percent. Deficit-free care is a bundle of 11 quality-improvement metrics. “Modifying the above areas helped improve things leaps and bounds based on data,” Ferguson said. Significant improvements happened with data collected on smoking cessation counseling and Cardiac Rehabilitation services. The data revealed gaps in smoking cessation services where certain outpatients wouldn’t get counseling or were unaware of the service. The data revealed that only inpatient smoking was monitored, demonstrating a process-improvement gap. Cardiac Services worked with Community Education to develop a model to get counseling for patients in need of smoking-cessation.
Through data analysis, the Cardiac Services team made adjustments and process improvements that will enhance the quality of care already offered to patients. “It’s a reflection that we aren’t just collecting data,” said Gilbert. “It’s that we are taking the data we get and sitting down and discussing it with the various groups. We take the numbers to people and say, ‘here are the numbers, how do we make it better.’”
This two-year project involved numerous departments working together to collect data that will help improve systematic processes and quality controls. “It’s collective, health care is not a single service,” Gilbert said. “There are many players involved.” With the information collected, the Cardiac Services team has the tools to consistently document and monitor patient data on a systematic and organization-wide level going forward.
About Tuality Healthcare
Tuality Healthcare, an OHSU Partner, is a leading healthcare provider in Washington County, serving a market area of 350,000 and growing. Tuality is a nonprofit, community-based organization with hospitals in Hillsboro and Forest Grove, and numerous physician and outpatient clinics.