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Posted October 30, 2013
ACH Earns "Top Performer on Key Quality Measures" Recognition from The Joint Commission

All Children’s Hospital in St. Petersburg, FL has been named a Top Performer on Key Quality Measures by The Joint Commission, the leading accreditor of health care organizations in America. All Children’s was recognized for exemplary performance in its pediatric measure: children’s asthma care. All Children’s is the only children’s hospital in Florida to earn this distinction.

“Our success is based on physicians, nurses and other clinicians whose commitment to patient- and family-centered care and evidence-based practice results in outstanding treatment and leads to improved health for our region’s children,” says Jonathan M. Ellen, M.D., president and physician in chief, All Children’s Hospital and professor of pediatrics and vice dean, All Children’s Hospital for the Johns Hopkins University School of Medicine.

“Childhood asthma is a leading cause of hospitalization among children, resulting in children missing school and activities, and parents having to miss work. We do more than provide excellent treatment when a child is admitted with an asthma attack—we also provide education for patients and parents aimed at successful management of asthma symptoms in order to prevent readmission to the hospital,” Dr. Ellen notes.

“This success reflects our overall approach to quality, involving multidisciplinary teams of physicians, nurses, pharmacists and other clinicians dedicated to setting and achieving goals for best practices.”

All Children’s is one of three Johns Hopkins Medicine hospitals to be named a Top Performer on Key Quality Measures. The Johns Hopkins Hospital in Baltimore, Maryland and Sibley Memorial Hospital in Washington, D.C. earned this designation as adult hospitals that consistently and at a very high level follow best practices for treating people who require surgery or suffer heart attacks, heart failure, stroke, pneumonia or other serious conditions.

“Our success is based on physicians, nurses and other clinicians whose commitment to patient- and family-centered care and evidence-based practice results in outstanding treatment and leads to improved health for our region’s children.”

Top-performing hospitals announced in this year’s report achieved at least 95 percent compliance with best practice processes of care, known as accountability measures, in one or more areas during the 2012 calendar year.

“This achievement reflects Johns Hopkins’ commitment to ensuring that our patients always receive evidence-based care that gives them the best chance of recovery,” says Paul B. Rothman, M.D., dean of the medical faculty and chief executive officer of Johns Hopkins Medicine.

“Delivering excellent care is part of our mission to improve the health of the community and the world,” says Ronald R. Peterson, president, The Johns Hopkins Hospital and Health System and executive vice president, Johns Hopkins Medicine.

“Academic medical centers care for the country’s sickest patients,” says Peter J. Pronovost, M.D., Ph.D., F.C.C.M., Johns Hopkins Medicine’s senior vice president for patient safety and quality. “The large volume of complex cases handled by these hospitals, which often have highly decentralized structures, makes implementing large-scale change especially challenging,” adds Pronovost, who also directs the Johns Hopkins Armstrong Institute for Patient Safety and Quality.

While the overall number of hospitals on the list soared this year, jumping to 1,099 hospitals — a 77 percent increase compared with the list released in 2012 — Pronovost says academic hospitals remain underrepresented.

An article that will be published in the December 2013 issue of The Joint Commission Journal on Quality and Patient Safety, yet is available online ahead of schedule, describes how Johns Hopkins Medicine implemented its high-performance goals. In that publication, Pronovost credited strong leadership at the top and “robust” improvement methods, measurements and a conceptual model. Pronovost says that 40 multidisciplinary workgroups were formed across the hospitals that make up the Johns Hopkins Health System. All six showed improvements, although only three earned the Top Performer designation this year.

Pronovost says the workgroup model fostered learning among teams, who included such diverse members as nurses, physicians, pharmacists and other patient care providers, as well as information technology specialists and quality improvement experts.

Pronovost attributes Johns Hopkins’ success in improving adherence with the accountability measures to an approach developed by the Armstrong Institute for Patient Safety and Quality to address challenges that often accompany quality improvement efforts, such as unclear goals, limited capacity for staff to conduct the work and too little feedback on performance. The safety experts’ model promoted high reliability by focusing on evidence-based care treatments, better communications, identification of specific opportunities for improvement, clear goal-setting, the use of processes that have proven successful in other high-risk industries such as aviation, and establishment of a wide system of accountabilities.

Each workgroup was paired with a faculty member and quality improvement coach. Faculty members provided patient safety expertise in their fields while coaches trained in Lean Sigma — a business methodology designed to create more efficient processes — helped teams identify the causes of setbacks and barriers to improvement.

To support transparency and accountability, each clinical unit, department and hospital was responsible for reporting on its performance. A formal accountability plan was implemented with increased reviews when performance failed to meet goals. Hospital presidents were responsible for reporting performance to boards of trustees, ensuring accountability from the board room to the bedside.

Workgroups also developed sustainability plans, which were approved by a quality coach and faculty member and presented to the trustees.

“We hope this is an approach that other hospitals can adopt as a framework for their efforts to improve the quality and safety of patient care,” Pronovost says.  

More details about Johns Hopkins’ approach to improving performance in the accountability measures are available in the December article authored by Pronovost and other Johns Hopkins Armstrong Institute experts in The Joint Commission Journal on Quality and Patient Safety.


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