Issue 3 - Fall - Providence Washington - Providence Health & Services

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Hospitalsin the United States rank amongthe best in the world. We areaccustomed to ultrasterile environments,high-tech electronicsystems and numerous redundantprocesses, all geared towardensuring that patient safety andclinical quality are maintained atall times. Still, things sometimesdon’t go as planned, even withinthe best medical centers. Patientssometimes get infections. They fall.They develop complications whenhard-to-diagnose conditions aren’tfound early. These are the reasonswe have many state and federalagencies solely dedicated to overseeingmedical processes, workingclosely with physicians andhospital leadership to ensure thatwe deliver the best care possible inevery situation.“There is significant governmentoversight on patient safety,plus major expectations fromstate, federal and private organizationsreporting our outcomes tothe public,” says Jeff Collins, MD,chief medical executive for ProvidenceHealth Care, which includesSacred Heart Medical Center &Children’s Hospital and ProvidenceHoly Family Hospital in Spokaneand two rural hospitals in StevensCounty. “But those regulations andexpectations mean nothing, really,if the hospital leadership doesn’thave a strong desire simply to dothe right thing, every time.”He adds: “That’s what we haveat Providence—a deep commitmentto be the best. Not for the sake ofawards, though these are evidenceof our work, but so patients knowthat they are in good hands.”Geriatric HipFractures: StartingSurgery SoonerIn 2009, Sacred Heart care providersdiscovered more could be doneto improve outcomes for hip fracturepatients, so the orthopedic teamdesigned the Geriatric FractureProgram to decrease hip fracturepatients’ wait time for surgery.“Evidence-based research showsthat the faster a patient with a fracturedhip goes to surgery, the fewercomplications they have postoperatively,improving their ability toget back to everything they enjoyedbefore acquiring a fracture,” saysnurse manager Tamara Sheehan, RN.The team—which includedorthopedic trauma and anesthesiaphysicians, orthopedic traumanurses and pharmacists—designeda process to improve the flow of ahip fracture patient’s process fromadmission to the orthopedic traumaunit and through surgery. Each teammember had a key role in ensuringessential tests and treatments werecompleted as quickly as possible.“One of the most fascinatingaspects of this project was to findthat the only cost of implementationwas the time commitment of theteam members,” Sheehan says. “OurGeriatric Fracture Program couldbe duplicated in any hospital wherea department is willing to work collaborativelywith others.”RESULTS:• The length of stay for hip fracturepatients at Sacred Heart decreasedby 0.7 days, getting patients backto their normal lives sooner.• This decrease in the length of stayfor 2010 and 2011 saved $371,000in labor costs.These innovators (from left:Michelle Egan, RN, Orthopedics;Jeff Liles, MD, Care Management;and Amelia Jay, Physical Therapy)have implemented processesthat help patients recover fasterand more completely from hipfractures and other illnesses.Providingsurgeries“At Providencewe have a deepcommitment to be thebest. Not for the sakeof awards, thoughthese are evidenceof our work, but sopatients know theyare in good hands.”20 ● Fall 2012 Heart Beat
forgeriatrichip fracturesASAPIS KEY.Immobility inthe ICU: GettingPatients MovingCritically ill patients are often immobilizedas a direct result of theirillness or because of the use of sedativesand pain medications. Beinginactive for a long period can causedelirium, weakness and pressureulcers, conditions that can result inlonger stays in the Intensive CareUnit (ICU) or another care unit.These conditions can also result ina decreased quality of life for thepatient after he or she returns home.“A mobility protocol that getsICU patients out of bed and walkingas early as possible, even whilethey are hooked up to a portableventilator, can decrease mortalityand improve quality of life for thepatient,” explains Mary Jo Moore,RN, nurse manager at Sacred Heart.To address those issues, theICU made changes in how patientswere weaned from their ventilators,adapted the use of certainmedications and involved physicaltherapists earlier.RESULTS:• Decreased length of stay in theICU and associated costs.• Reduction in complications relatedto prolonged ventilator use.• Improved patient, family and physiciansatisfaction.• Reduced the patient’s time on theventilator by almost a day.• Reduced the patient’s hospital stayby 1.3 days.Fall 2012 Heart Beat ● 21
Page 1 and 2: heartbeatprovidenceQuality health c
Page 3 and 4: providenceheartbeatExecutive Editor
Page 5 and 6: {mailbag}Living LargeFormer heart t
Page 7 and 8: Medical Park Comingto Spokane Valle
Page 9 and 10: Home, Safe HomePrevent falls with a
Page 11 and 12: Experts Ready —In Case NeededAll
Page 13 and 14: Yet, patients don’t always ask it
Page 15 and 16: Shortly aftermoving to Spokane four
Page 17 and 18: Lily Wittich, MDJonathon Anderson,
Page 19: From falls to infections to many th
Page 24 and 25: Katherine Tuttle, MD,a Providence S
Page 26 and 27: “I’m eternally grateful that he
Page 28: {Sustainable efforts}Going GreenWit
Page 31 and 32: Is your lifecontrolledby drugs oral

Issue 3 - Fall - Providence Washington - Providence Health & Services

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