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GPOs – Valued Partners in Healthcare
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The healthcare group purchasing organization (GPO) members of HSCA work closely with their provider partners across the continuum of care to reduce cost, add value, and improve outcomes for patients. Below you'll find some narratives that help to demonstrate why GPOs are valued partners in healthcare.

 

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New Lighting Improves Safety, Reduces Costs

Posted By HSCA, Thursday, January 14, 2016

CHALLENGE

As an award-winning Level 1 trauma center, Presence Saint Francis Hospital in Evanston, IL, encourages family involvement in the healing process. Its 24/7 open visitation policy drives a steady flow of vehicular and pedestrian traffic into its parking garage. However, inadequate lighting that resulted in limited visibility in many areas made the environment seem unsafe to visitors and staff. A new lighting solution was needed.

The garage originally had yellow high-pressure sodium (HPS) fixtures, said Joe Stark, regional director, support services for Presence Saint Francis and Saint Joseph hospitals. “The yellow light did not give a sense of safety and security to people. I’m a huge advocate of bright, daylight-like light and the sense of security it gives to people,” he said.

The HPS fixtures also required expensive, ongoing maintenance to replace bulbs and ballasts as well as electricians’ time and that of another person to monitor garage traffic while electricians did their work.

SOLUTION

Stark challenged Grainger, a Premier, Inc. (NASDAQ: PINC) contracted supplier, to help him find the best lighting solution for the garage. Working with a Grainger healthcare account manager, Stark evaluated lighting options. He looked initially at retrofitting existing fixtures with an LED lamp. But he was disappointed with the look of the fixtures and the quality of the light.

“Nothing looked good until we put in the sample Cree® VG Series parking structure and Cree Edge™ area LED luminaries,” Stark said. “The light output, the fixture itself, the different coloration of the lumens – it was completely different, from yellow to white. As the replacement happened level by level, you could clearly see that Cree had the right fixture for the right application.”

RESULT

The new optimal light quality resulted in a greater sense of security for visitors and hospital staff while significantly reducing operating and maintenance costs.

Stark heard right away from the Saint Francis security manager who noted that security camera output was clearer. The white light made it possible to read license plate numbers and see other details easier.

Staff noted the improved visibility. The Presence Network News, the corporate newsletter, did a story on the garage lighting. “They interviewed one of the hospital employees who indicated she felt much safer with the new lighting as she walked from her car during second and third shifts. A sense of security in the parking garage is very important to the hospital employees and to me. I want our staff and visitors to feel safe when they come here.”

The Cree VG Series parking structure and Cree Edge area LED luminaires not only provide optimal light quality, instilling a greater sense of security to hospital staff and visitors, but reduce operating costs and deliver energy savings.

Lighting maintenance has gone from ongoing to minimal, freeing maintenance staff for other projects. “Before the lighting change, maintenance crews were changing out lamps or ballasts at least every other week. Now with Cree, we haven’t been in the garage since,” Stark said.

A multi-level sensor chosen by Presence Saint Francis Hospital automatically lowers output from 100 percent to 25 percent after seven minutes of detecting no vehicle or pedestrian movement. That qualified the project for a large rebate from ComEd, the local electric utility.

Tags:  Cost  Illinois  Premier  Safety/Quality 

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Member Best Practice Spotlight: Verde Valley Medical Center – Medication Strategy for Value-Based Performance

Posted By HSCA, Thursday, January 14, 2016

As we recognize American Diabetes Month, this week’s blog post looks at how Verde Valley MedicalCenter initiated a medication compliance program to benefit patients with chronic conditions including diabetes.

Issue
Verde Valley Medical Center’s (VVMC’s) performance data identified an opportunity to meet the needs of the diverse local community of Native Americans (Yavapai Apache Nation), Mexican immigrants and senior citizens who face challenges in medication compliance.

Solution
Through a collaborative effort involving pharmacy, nursing and medical staff, VVMC identified the most common medications a patient is prescribed at discharge and developed unique cards to enhance performance outcomes – 18 “drug family” cards and two “take home facts” information cards. The cards are provided to patients during care as medication is dispensed and at discharge during medication reconciliation. This gives the caregivers and the patients easy-to-understand information “in hand” and provides the opportunity for caregivers to have ongoing discussions with patients, especially in the management of chronic conditions – diabetes, cardiac and respiratory therapy, as well as pain and antibiotic use.

Outcome
The data improved from patient satisfaction and government mandated value-based purchasing perspectives. Re-admission rates decreased while patient satisfaction, education and discharge instructions increased. Additional stakeholders in the community were identified.

About Verde Valley Medical Center
Formed in 1939, Verde Valley Medical Center is a full-service, 99-bed, non-profit hospital serving North Central Arizona. Four locations serve the Verde Valley and surrounding communities: Cottonwood campus, Sedona campus, Camp Verde Health Center, and Village of Oak Creek Health Center. More than 800 professional and support staff are employed at VVMC. The Medical Staff is comprised of nearly 100 physicians representing 25 medical specialties. We are a member of Northern Arizona Healthcare, which also serves patients through Flagstaff Medical Center, Northern Arizona Homecare and Northern Arizona
Hospice.

Tags:  Arizona  Intalere  Safety/Quality 

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Intalere Member Verde Valley Medical Center Improves Patient Safety and Reduces Patient Falls by 40 Percent

Posted By HSCA, Friday, September 18, 2015
Updated: Thursday, November 26, 2015

The Challenge

Nurses are widely recognized as the foundation of the healthcare system. Oftentimes, they are the leaders in helping an organization achieve successful outcomes in clinical, patient safety, operational quality and regulatory compliance. And with the advent of pay-for-performance models, registered nursing is becoming an increasingly important job with enhanced responsibilities. Such is the case at Verde Valley Medical Center (VVMC) in north central Arizona. When the number of patient falls was rapidly rising within the organization, it was the nursing staff that took the lead at addressing the issue and helping to create a system-wide improvement initiative. 

VVMC began as a small outpatient clinic in 1939, but has since grown into a full-service, 99-bed, nonprofit hospital with four locations and more than 800 professional and support staff. VVMC is a member of Northern Arizona Healthcare, which also serves patients through Flagstaff Medical Center, Sedona Medical Center, Northern Arizona Homecare, Northern Arizona Hospice and multiple outpatient clinics.

“Our organization had policies in place and a system for reporting patient falls, yet our fall rate increased significantly in one year,” said Cat Singletary, manager for Performance Improvement and Regulatory Compliance at VVMC. “Clearly something was broken and our nursing staff was instrumental in telling us what works, what doesn’t and what needs to change. They are in the trenches every day and they have the best understanding of how to help make the care we provide to our patients better.”

The Solution

The Quality Department at VVMC created a multi-disciplinary committee from Nursing, IT, Pharmacy, Therapy Services, Risk and Compliance Departments of both VVMC and Flagstaff Medical Center. This new Falls Prevention Committee met monthly to review huddle sheets, event reporting, policy, equipment, patient and staff education, documentation procedures, etc. 

“The Falls Prevention Committee requested that both facilities conduct a baseline assessment and to interview staff. Internal audits were conducted and the data was shared with the committee. This information was critical in identifying the gaps in our processes and procedures,” noted Singletary. 

One example, the nursing staff was not completing the huddle sheet because it was too cumbersome and it did not mirror the fields in the patient events reporting system (Remote Data Entry (RDE)). 

Another example, the patient alarms were used sporadically since policy did not state it was a requirement. In addition, VVMC’s staff worked with their Evidence Based Practice and Research Department to identify best practices on patient falls.

“Our goal is to provide exceptional care, always. Through our research, we identified that educating the patient and their caregivers was key as well as posting visual prompts in the rooms to remind patients to ‘call, don’t fall,’” said Lori Stevens, VVMC’s Director of Nursing.

At the conclusion of the assessments, interviews and evidence-based research, the Falls Prevention Committee took several weeks to develop and then launch their initiative across the organization.

First and foremost, forms and policies were updated and standardized. The post-fall huddle sheet was condensed and the information being captured was aligned with the information in the RDE system. The committee worked closely with Intalere’s supplier Posey to test and roll out new chair, bed and bathroom alarms on all units of both hospitals – which are now required for all patients and even documented in the huddle sheet, RDE system and patient medical record.

Nurses have the greatest amount of patient contact during hospitalization and are the best suited to assess the risk for patient falls. This is where attention was focused. 

“We updated our training documents, posted educational flyers, attended daily huddles, revised our mandatory falls learning module and conducted several other education sessions for our staff.  All in all, we touched more than 1,000 nurses through this process. Nurses are most likely to witness falls and have the greatest power to prevent falls. Therefore, providing them the education and tools they need to be successful was the focus point for our initiative,” noted Stevens.

VVMC took a more proactive approach to new patient and family education than it had in the past. Call Don’t Fallsignage was placed in all patient rooms and bathrooms.

Plus, the community was invited to a Health and Safety Fair at its facility which included education about falls prevention and other population health management issues, but also offered additional activities including blood pressure checks, eye screenings and well woman health checks.

The Patient Falls Committee also implemented STATIT, a real-time analytic software program that is geared towards continual improvement. This program provides users a simple yet powerful means to access, track, trend, analyze, compare and contrast data in ways that provide insights from which to make objective, sustainable and defensible decisions.

By utilizing STATIT, both hospitals were able to collect data, identify trends and provide high quality fall reports to the nursing units and senior leadership. 

Singletary commented, “Through this whole process we discovered the importance of keeping patient falls at the top of our minds. Our Quality Department now attends all patient care huddles. These huddles happen every morning, Monday through Friday, for about five to ten minutes. Patient falls are reported on at each huddle, every time. Simply having this brief overview and knowing how many high-risk patients are currently in the unit can really impact the care we deliver to our patients.”

The Outcome

In nine months since implementing the new Patient Falls Initiative, VVMC achieved over 40 percent decrease in falls. This alone represents tremendous savings to the organization considering The Joint Commission reports that the average increase in a hospital's operational costs for a serious fall-related injury is more than $13,000, and the patient's length of stay increases by an average of 6.27 days.

“This was a huge quality improvement effort for our organization – the first large collaborative effort to create one unified nursing process between systems. Not only did we standardize processes between two hospitals, but we increased the safety of our patients, increased patient and family satisfaction and reduced the costs associated with patient falls,” said Singletary.

Costs for implementing the recommendations of the Patient Falls Committee were nominal to the organization. Most costs were associated with staff time at meetings and revising policies and forms. The Call Don’t Fallsignage was printed in-house to reduce expenses and the Supply Chain Department utilized the Intalere agreement with Posey for purchasing the new alarms.

Using best practices and listening to its staff continues to be a focus for the system. The organization is continuing the positive momentum by testing new shower chairs in its post-surgical care unit since the nursing staff voiced the need for a wider and sturdier chair to help prevent falls. 

“I’m extremely proud of our nursing team and the entire organization for their commitment in identifying patients at highest risk for falls and for developing falls-prevention strategies. While not every patient fall is preventable, I believe that the right combination of education, technology, care processes and focus can reduce the number of falls significantly and, more importantly, the injuries to patients they often cause,” said Stevens.

Tags:  Arizona  Intalere  Safety/Quality 

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GNYHA Services Partners with Hospital Colleagues to Reduce Infection Rates

Posted By HSCA, Tuesday, September 15, 2015

Several years ago, the team at GNYHA Services partnered with our GNYHA hospital colleagues to address central line-associated bloodstream infections (CLABSIs). Through an Association-based CLABSI reduction collaborative, area hospitals became aware that patient care workers often lacked the proper materials required to insert a central line at the point of care, prompting them to improvise with other supplies. Over time, this practice increased the infection rate.

Through the collaborative, GNYHA Services worked with an interdisciplinary CLABSI reduction team to develop central line kits. These kits packaged all of the supplies needed to insert a central line (drape, tubing, catheters, gowns, etc.) in one bundle. When area hospitals adopted these kits, CLABSI rates in the ICU dropped by 54%, with 53% of collaborative hospitals reporting no infections for six or more consecutive months. This case is just one example of the power of supply chain innovation to solve a problem and foster a significant overall improvement in patient outcomes, ideally leading to shorter hospital stays and fewer readmissions.

Tags:  GNYHA  New York  Safety/Quality 

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