Baylor system takes annual NQF quality award
Baylor system takes annual NQF quality award
Anatomy of a winning initiative
Baylor Healthcare System, based in the Dallas/Ft. Worth area of Texas, has been named the recipient of this year's National Quality Healthcare Award by the National Quality Forum (NQF).
The award, says Janet Corrigan, PhD, MBA, CEO and president of NQF, is given to recipients who demonstrate "a very high level of commitment to quality throughout the organization — with regular reports that flow to the board and senior management." This year, she adds, NQF paid special attention to the management of patients with chronic illness across time and over different settings. "It's also really important to have a strong commitment to transparency," she adds.
Baylor, says Corrigan, was ranked high by the jurors across many areas, "but in particular they went above and beyond the call of duty when it came to measuring quality and making it part of everyone's job within the organization. There was constant feedback on performance going to clinicians, and all members of the care team."
"Our quality and patient safety goals are tied to senior management bonuses — it's part of a balanced scorecard we use," notes Paul Convery, MD, senior vice president and chief medical officer for Baylor Healthcare. "We have great outcomes, we share information on our web site with the public, and we are transparent internally as well."
Anatomy of an initiative
A close look at an initiative to standardize the clinical approach to pneumonia patients provides insight into the way Baylor approaches QI. "We had a group of physician leaders convene and look at the evidence and develop an evidence-based order set for the care of pneumonia," says Convery. "Then, we brought it to our systemwide quality committee [the system has 13 hospitals], which is not only made up of senior leaders and physicians, but is attended by all the hospital presidents." This "best care committee" then approved the order set.
Next, says Convery, he and other quality leadership selected a group of physician champions, whom Baylor pays "a small amount" for their time.
Prior to rollout, many of the key individuals took a course called "ABC Baylor," a seven-day QI class spread out over a few months that teaches both quality leadership and QI processes. "Senior management, hospital presidents, doctors, nurses, administrators all go through it," says Convery. "As part of the class, each participant has to do a PI project."
So far, he says, about 600 people across the organization have gone through the full course. (A shorter two-day course has reached another 1,000.) They are taught by internal faculty. "We encourage everyone who is new to take the course as soon as possible, but when you work on an initiative, you definitely do it; for instance, it's part of being a physician champion," Convery explains.
Following implementation, measurements were taken for both compliance and performance. "In this case we found a couple of places that had not rolled out very much, and we focused on accountability at those hospitals," says Convery.
Specific action plans were developed to help improve compliance. "It involves nurses and physicians, then it goes to the system quality department, then it comes to me, and I review it," says Convery. The board will even ask about issues such as these, he says. "Accountability is a big part of how we approach quality," he notes.
Today, the order set is used in 80% of all Baylor pneumonia cases. "We have shown that it has contributed to high core measure scores, reduced morality rates and improved patient care," he asserts.
The information system at Baylor enhances the team's ability to measure results, he continues. "We have the ability to get outcomes almost on a real-time basis — a few weeks after the data close," says Convery. "We have a good data system and people that respond."
[For more information, contact:
Paul Convery, MD, Senior Vice President and Chief Medical Officer, Baylor Healthcare System.
Janet Corrigan, PhD, MBA, CEO and President, National Quality Forum, 601 13th Street NW, Suite 500 North, Washington, DC 20005. Phone: (202) 783-1300.]Baylor Healthcare System, based in the Dallas/Ft. Worth area of Texas, has been named the recipient of this year's National Quality Healthcare Award by the National Quality Forum (NQF).
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