When St. Joseph Medical Center in Tacoma, WA, was recognized as the only hospital in Washington state to earn the 2019 Top Teaching Hospital award from Leapfrog Group, it was the result of a team effort among advanced practice providers, hospitalists, and specialists.

The award also was the result of the hospital making itself a data-driven organization that is supported by a robust quality and clinical effectiveness department, says Tim O’Haver, vice president of operations and chief operating officer at St. Joseph Medical Center. “The focus on data ensures the process improvement work we’re engaged in is focused and specific to achieving improvements across a broad array of clinical measures and care processes,” O’Haver says. “This has also been facilitated by clinical integration across the care continuum. Ambulatory care programs work to identify, intervene, and mitigate certain risk factors that we know influence wellness and health outcomes in the acute care setting and beyond.”

The hospital’s success was made possible by collaboration among the acute care, ambulatory, and outpatient components of the facility, O’Haver reports. Leapfrog recently announced changes to the 2020 survey process, including an option for hospitals to maintain their 2019 survey results in lieu of reporting for the 2020 Leapfrog Hospital Survey. (See the last story in this issue for details about the changes.)

Leapfrog categorizes hospitals as a general, children’s, rural, or teaching hospital, assessing them with a value-based purchasing program methodology that includes measures for maternity care, medication safety, and inpatient surgery. St. Joseph Medical Center, part of the CHI Franciscan health system, has a comprehensive SafetyFirst program that strives for safety and reliability performance improvement, O’Haver says. All new employees must complete training in SafetyFirst methods, which are based on reliability science and human performance in complex systems, he adds.

“The program was launched here in 2014. We’ve seen year-over-year improvements in care since the program’s inception across CHI Franciscan. Of course, none of this would be possible without the full support and engagement of the combined healthcare team,” O’Haver acknowledges. “We have worked diligently to foster and enrich a culture of safety here at St. Joseph Medical Center that values a multidisciplinary approach and one that encourages the reporting of near misses.” O’Haver cites these specific initiatives that contributed to the hospital’s overall quality improvement:

  • Developed a Quality and Safety Leadership Council structure with performance improvement teams addressing key initiatives;
  • More attention on documentation and coding to accurately reflect the acuity of the patient’s condition during stay in hospital;
  • Ensuring structures and processes are in place to meet the Leapfrog performance standards, such as computerized physician order entry, intensive care unit staffing, and National Quality Forum Safe Practices;
  • Implemented multidisciplinary care rounds, which involves bedside nursing, care management, social work services, clinical documentation improvement staff, and hospitalists who can sync the care plan with good communication.