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Kentucky hospital saves close to 400 lives
Getting 'Board on Board' initiatives one key to success
Sometimes large numbers don't hit home as much as smaller ones. When the Institute for Healthcare Improvement launched its "5 Million Lives" campaign, the concept of saving five million lives was almost too large to get one's mind around. But when the Owensboro (KY) Medical Health System announces that by participating in the campaign it has saved nearly 400 lives, that can really grab your attention.
Part of the reason for this success, says Lisa Thompson, the system's director, quality improvement, is that it was part of the campaign right from the beginning. "We joined the day the IHI announced it," she says, adding that the system already had been participating in the predecessor "100,000 Lives" campaign. "Our CEO was sitting in the audience at IHI's national forum, and when they announced it, he knew our hospital was going to be one of the participants. He got out of his chair and said we wanted to be part of it." Thompson notes that Owensboro also had done several IHI collaboratives and had participated in all six projects in the "5 Million Lives" campaign.
Another key was the successful implementation of the "Getting Boards on Board" initiative. "When they announced the 'Five Million Lives,' we were doing all those initiatives except for getting the board on board," says Thompson. "We talked about quality in [board] meetings, but I don't know that anyone ever really understood it."
Getting board 'on board'
So, how did Owensboro implement the initiative? "We got the IHI how-to guide [available free of charge on the IHI web site], pored over it, and started implementing it," says Thompson. "Then, the IHI held sessions on the topic and we took several board members, who were educated by IHI faculty." Whenever someone new joins the board, she says, "that's now one of the first things we do."
The hospital already had in place a subcommittee of the board that dealt with quality, "but they had looked at it more from the aspect of finance; their main function was assessing equipment," Thompson explains.
The committee was totally restructured and renamed the "board quality and safety committee."
"They do not talk money at all now," says Thompson. The committee is made up of some board lay people, physician board members, and physicians from the medical staff.
"We also have a medical quality committee, which reports to them," Thompson adds. "It's all physician-driven. The patient safety committee is also led by a doctor, and he makes monthly reports to that committee."
In addition, says Thompson, quality is now the first topic on every board agenda. "That's what it recommended in the 'how-to' guide," she explains.
Quality at the hospital "has risen several notches" as a result of the initiative, Thompson asserts. "The board always said its focus was on quality, but now they actually do focus and look at quality in a more in-depth manner; they ask questions, they are involved," she says. "The doctors appreciate getting a chance to talk about their work and what we as an organization have accomplished." It's made a difference with the medical staff and clinical staff "because the board has a better understanding of what we do and how it impacts our outcomes," she adds.
How does Thompson know that 400 lives were saved? "We took our patient population and said, What would happen if we continued to practice at the same rate we were, and we multiply it out,'" she says. "Say five years ago our mortality rate was 10% and now it's 2%. You take your number of patients and multiply by 10%, and that's where we would be if we had not done the interventions."
Thompson concedes that this method may not be high statistics, "but it helps people understand, and it makes it real — one of them could have been my Mom or Dad."
It's an effective way of grabbing the public's attention, she continues. "When I tell you I decreased our mortality rate by 20%, people will see that and say, 'So what?'" she notes. "But if I say we made a difference for 480 people, they say 'AHA!' It gives you a much better picture of what we're doing."
[For more information, contact:
Lisa Thompson, Director, Quality Improvement, Owensboro Medical Health System, 811 East Parrish Avenue, Owensboro, KY 42303. Phone: (270) 688-2868. E-mail: email@example.com.]