Care on the Cutting Edge

Indiana hospitals participating in the Hospital Improvement Innovation Network come together to share best practices and improve care

Indiana hospitals have long been leaders in the quest to improve quality, and their active participation in the Hospital Improvement Innovation Network (HIIN) is just one example of their commitment to making care safer for patients across the state. Currently 104 hospitals are participating in the initiative, which aims to reduce all-cause harm by 20 percent and readmissions by 12 percent by 2019. The Indiana Hospital Association (IHA) is partnering with the American Hospital Association’s Health Research and Educational Trust (AHA/HRET) on the HIIN by providing support and resources to hospitals.

“Through the HIIN, hospitals have access to patient safety coaches, toolkits, in-person trainings and web-based educational offerings,” says Karin Kennedy, administrative director of IHA’s Indiana Patient Safety Center. “The HIIN offers a tremendous opportunity for hospitals to learn from one another.”

Becky Hancock, RN, IPSC patient safety and quality advisor, agrees that the resources the HIIN provides are invaluable to hospitals. She notes that they not only provide useful information but also save hospitals time and effort.

“Instead of querying the literature, HIIN sites have ready access to the evidence-based practice standards for harm and readmission reduction,” Hancock says. “I believe the educational webinars from innovative hospitals, combined with HIIN evidence-based practice resources, will help meet the HIIN goals by inspiring staff in their harm reduction initiatives.”

Between Jan. 10 and March 20 of this year, the IPSC team made 102 site visits to participating hospitals, visiting 89 of the 92 counties in the state and traveling approximately 15,000 miles. During these site visits, the team meets with hospital staff to discuss their work and provide assistance as needed.

“Traveling across the state to visit with our hospitals has been inspirational to me simply because I have witnessed a true sense of passion for patients,” says Madeline Wilson, RN, IPSC patient safety and quality advisor. “Even with the challenges that our state has experienced in health care, our hospitals continue to collaborate with each other, work hard and focus on best practices.”

Ultimately, the HIIN provides hospitals with an opportunity to learn from one another and discuss what has—and has not—worked for them. Through these connections and this knowledge, hospitals can create and implement their own initiatives to tackle their most pressing safety concerns.

“The HIIN provides a library of resources and platform for health care organizations to network with others from across the country who would not have otherwise crossed paths,” says Annette Handy,  RN, IPSC clinical director. “Having an opportunity to share successes and challenges will further advance the work of not only individual hospitals but also regions, states and the nation.”


STATE SUCCESSES

Here are just a few examples of the successful initiatives Indiana hospitals have implemented as they work to improve quality and patient safety at their facilities.

Franciscan Health Michigan City
Initiative: Early progressive mobility
“We hired a mobility team to help us develop a standardized approach to mobility and use common mobility language. We’ve seen a 39 percent reduction in discharges to nursing homes and 70 percent reduction in pressure ulcers.”
Brooke Nack, inpatient therapy manager

IU Health Ball Memorial Hospital, Muncie
Initiative: Hand hygiene
“Hand hygiene is pushed from executive leadership all the way down, starting at orientation. It’s the simplest thing to do, and it has the biggest impact.”
Cherlynn Bennett, RN, manager, office of quality and safety/infection prevention

Memorial Hospital and Health Care Center, Jasper
Initiative: Safety huddles
“In January 2016, after researching best practices, high-reliability organizations and Baldrige Award-winning facilities, we implemented daily safety huddles using a standardized agenda. Notes are posted on our intranet within two hours. Leaders and staff are demonstrating more situational awareness and report proactive interventions at the huddle.”
Denise Kaetzel, RN, director of quality services

IU Health Blackford Hospital, Hartford City
Initiative: Hand hygiene
“We’re a smaller hospital, so we’re able to include every staff member in the peer observation process. We post the data every week using a fun and engaging ocean visual on which each department’s life preserver moves depending on the results. Staff have responded well, and we’re doing better every month.”
Laura Spaulding, respiratory therapy lead clinician

Columbus Regional Hospital
Initiative: Sepsis reduction
“In 2014 we began focusing on how we were treating patients with sepsis and complying with the CMS bundle. Our total mortality rate for sepsis dropped from just under 20 percent in 2014 to 5.7 percent in 2016. Being able to show physicians the data and the results of their efforts has been really impactful.”
Lee Kiser, M.D., hospitalist and physician champion

Memorial Hospital of South Bend
Initiative: Falls reduction
“After we established a multidisciplinary team to help us develop a standardized approach to falls prevention, our fall injury rate dropped 30 percent. Involving frontline staff in the decision-making process has been the ticket to our success.”
Sarah Paturalski, executive director of inpatient adult and psychiatric services

Parkview LaGrange Hospital
Initiative: Meeting the unique health care needs of the community
“LaGrange County has one of the largest Amish populations in the state. We partner closely with the community to ensure we’re meeting their needs in a variety of ways, from our ‘Share the Road’ Program that provides safety vests to increase visibility on the roads to including Amish representatives on our patient and family advisory committee and the hospital’s board of directors.”
Jordi Disler, president

Pulaski Memorial Hospital, Winamac
Initiative: Medication reconciliation
“We implemented a LEAN Rapid Improvement Event to break down our current process of obtaining the best possible medication history from patients and identify solutions. Our rate of confirmed home medications was 43 percent when we started and is now up to 94 percent.”
Linda Webb, RN, CNO

Greene County General Hospital, Linton
Initiative: Workplace violence prevention
“By hiring law enforcement officers and having that physical presence in the hospital 24 hours a day, seven days a week, it’s very visible that we value and prioritize safety. It has improved our relationship with local law enforcement and reinforced our commitment to customer service.”
Brenda Reetz, RN, CEO

Witham Health Services, Lebanon
Initiative: Leadership and board rounding
“Our board is invested in helping us establish a just culture and improve quality. They spend more time discussing quality improvement indicators than anything else at their meetings, and one board member comes in once a month to talk to staff, while another board member comes in twice a week to talk to patients.”
Ray Ingham, Ph.D., FACHE, president/CEO

St. Vincent, Indianapolis
Initiative: Communication of quality efforts to frontline staff
“We send out a newsletter each month that contains quality indicators and unit-level dashboards as well as tips and tactics to improve outcomes. The frontline staff see the data as important to them  Because it’s their data and their work.”
Stephanie Tooley, D.N.P., RN, executive director of quality

Dearborn County Hospital, Lawrenceburg
Initiative: Patient and family engagement
“The members of our new Patient and Family Advisory Council help us see what we don’t see about ourselves. They bring the patient perspective to the table and remind us that their needs are our needs.”
Debby Allen, chaplain and patient advocate