In its efforts to achieve the Triple Aim quality goal, Lafayette (LA) General Health has implemented flexible systems, along with standardized equipment and monitoring solutions that improve patient safety and overall quality at the health system.
The Triple Aim is a framework for healthcare improvement based on three primary goals: improving the patient experience, improving the health of populations, and reducing the per capita cost of healthcare. Implementing a new electronic record and electronic monitoring system was a significant step forward for the Lafayette hospital, says Jamie Gonzales, RN, BSN, clinical educator at Lafayette General Health.
The new monitoring system was only part of the effort, Gonzales says. One task was to gain a better understanding of the patient experience and to improve that experience. A better interaction among staff also was desired, so Lafayette asked employees to define what they expect from their coworkers. The health system educated frontline staff on the importance of small gestures such as introducing themselves properly to patients and coworkers.
“It was the little tiny things that overall made a huge impact on the perceptions of both patients and employees,” Gonzales says. “Our quality measures weren’t what we wanted, so we started making rounds daily through every single floor, even on the weekend, to ensure that every single core measure was met and no one was left behind.”
Much of the improvement effort focused on empowering nurses. Lafayette also implemented hourly rounding by nurses, which reduced falls and improved outcomes overall, Gonzales says. The clinical education department was completely rebuilt to provide more thorough and ongoing education beyond initial orientation.
The new electronic system provides more real-time monitoring to detect early changes to vital signs, bed exits, pressure ulcers, and respiratory failure. This monitoring has led to 75% reduction in mortality rates and 40% reduction in cost of care. Custom alarms also alert staff before the trouble occurs, such as when a patient is trying to exit the bed. Vital signs errors have been reduced by 75%.
For a typical 200-bed hospital, this change alone can equate to savings of $2 million in operational costs, says Garrison Gomez, senior director of vital signs and cardiology for the United States and Canada at Welch Allyn in Skaneateles Falls, NY.