Selected Podcast
Ep. 12: Success Stories on Our Journey to High Reliability
On this episode of Inspiring Health, we’re picking up on a conversation we began in episode two of the podcast - about our journey to high reliability. Today, we’re going to discuss our progress to achieve top decile results in quality and safety. As a healthcare organization, nothing is more important than delivering the safest, highest-quality care.
Featuring:
Eugenia Powell, PhD, RN, NEA-BC, CPHQ | Roxanna Gapstur PhD, RN
Eugenia Powell, PhD, RN is Vice President, Patient Safety and Quality. Transcription:
Michael Carrese: You're listening to Inspiring Health with Dr. Roxanna Gapstur, President and CEO of WellSpan Health as she hosts candid conversations about organizational culture, value and other pressing issues we face in healthcare and business today, Roxanna. Tell me what we're going to be talking about today.
Roxanna: On this episode of Inspiring Health, we're picking up on a conversation that we began in episode two of the podcast about our journey to high reliability. Today, we're going to talk about identifying key metrics and quality and safety, also data-driven continuous improvement initiatives that have put us on the right track. And finally, we'll give a call to action regarding our Heads Up, Speak up program and invite our listeners to spread the word about our award-winning care.
Joining me today is Dr. Eugenia Powell. Eugenia is our Vice President of Patient Safety and Quality. She leads all patient safety and quality teams across the organization. Welcome, Eugenia. Thanks for joining me today.
Eugenia Powell: It's my pleasure to be here, Dr. Gapstur. Thanks for having me.
Roxanna: Oh, please call me Roxanna. So we started this conversation about high reliability with Mike Seim, our Chief Quality Officer last July. You joined our organization recently, Eugenia, in November and I wanted to start our conversation today the same way we did with Dr. Seim. What does high reliability mean to you, Eugenia?
Eugenia Powell: Well, Roxanna, high reliability means all patients can trust that we are providing the safest and most reliable care by reducing defects and errors. You know, patients come to us thinking they will not be harmed. As a highly reliable organization, our job is to recognize early warning signs of deviation or variation and take the appropriate actions. We are on a journey to zero harm. We can keep our patients safe by using the standard work lean strategies, tools, and principles that have been deployed at WellSpan.
Roxanna: That's great, Eugenia. You know, you're a nurse by trade, so how does your clinical experience inform your perspective about high reliability?
Eugenia Powell: Yes. As a nurse, delivering quality care and keeping patients safe and free from harm are the most important elements to care delivery. Very early in my career, I was a nurse leader in an organization where an infant was mistakenly administered more than three times the amount of the prescribed narcotic. You could only imagine, while that event did not occur in my clinical area, it still resonates for me today and has shaped my perspective on quality and safety.
As an industry, the bar has moved up over the years, but we're not there yet. The goal is zero harm. As nurses and as stated in our code of ethics, we have the duty to do no harm. We are human, so errors may occur, but that is why we strive for high reliability. A consistent proactive error reduction approach to care provision, injury and harm can be prevented.
As a nurse and as clinicians, we are obligated to provide safe care. All patients and families trust their loved one to us and it is our job to be competent, transparent, ethical, utilize best practice and stay in the mode of continuous learning.
Roxanna: I couldn't have said it better, Eugenia. I appreciate that perspective, having begun my career as a nurse as well. And it aligned so well with the organizational mantra that we have to establish high reliability. It's the right care at the right time in the right place. Consistency is key and is the minimum that our consumers should expect from us.
Now, we can track our progress using key metrics like safe opioid prescribing, or time and range for anticoagulants, patient experience scores, hospital-acquired infection rates, et cetera. These metrics are important and many of them are included in some of our national publicly reported quality measures like CMS and Leapfrog scores as well as our Medicare shared savings quality scores.
In fact, as we think about our move to value, many of these quality and safety metrics are also required by our payer partners. We know our patients and communities also have access to these measures online and they can compare WellSpan to other healthcare systems in our region. Eugenia, what's the value in some of these metrics like Leapfrog or CMS ratings to our consumers or community members?
Eugenia Powell: Well, Roxanna, Leapfrog is a national organization and it's one of many. It sets the toughest standards for healthcare quality and safety. Leapfrog assigns grades A to F to thousands of hospitals across the country twice a year. These grades are made available to consumers. Similarly, CMS assigns star ratings to hospitals across the country each year, like hotel ratings. Hospitals may receive a one star up to a five star, which is the best.
Organizations or groups like Leapfrog and CMS are informing healthcare decisions by putting the right information into a consumer's hand. It encourages consumer choice and it is needed because few resources exist to help consumers choose the best care.
Roxanna: So Eugenia, are all hospitals and medical groups the same when it comes to these publicly reported measures?
Eugenia Powell: No, I'm afraid not, Roxanna. All hospitals and medical groups are not the same. One of the benefits of groups such as Leapfrog and CMS is that consumers can get an idea for how different organizations compare on quality and safety. You know, I've worked in a number of healthcare organizations and I'm grateful to be part of the WellSpan team where it is clear that quality and safety across the system are the priorities for our work.
We just don't speak the language, but we identify and then take the necessary actions to improve. Our values, like find a better way and do the right thing, create the right foundation for us to think about quality and safety every day. And our lean management system gives us the tools to improve towards high reliability.
Roxanna: You know, that's a great segue, Eugenia, to talk about how we're differentiating ourselves at WellSpan. As part of our 2025 strategy, we've set out to achieve industry-leading safety and quality outcomes in our hospitals and medical practices. And recent indicators tell us we're on the right track. Can you share a few of those success stories with our listeners?
Eugenia Powell: Sure. These are success stories that we can all be really proud of. Our medical group has received a score of 96% on the most recent CMS Accountable Care Organization quality metrics. This tells us that we perform at a very high level across our medical group when it comes to quality and safety. We've also just recently learned both Ephrata and Chambersburg hospital received five star ratings from CMS. Five star ratings, Roxanna. Waynesboro, Gettysburg, Good Samaritan, York hospitals, all received four stars. The star ratings include more than 57 measures of both quality and safety for hospitals. We're very proud of that.
When it comes to our most recent Leapfrog safety scores, the Chambersburg and Waynesboro hospitals were both named 2020 Leapfrog Top Teaching Small Hospitals. This is the first time a WellSpan Hospital has received a top hospital award from Leapfrog. In addition to receiving that award, Chambersburg, Ephrata, Gettysburg and York Hospitals, all earned A safety grades from Leapfrog.
Another success story is that we were recently honored with 12 American Heart Association, American Stroke Association Get With The Guidelines awards at six of our acute care community hospitals for achievements in stroke and heart-related care. Chambersburg, Ephrata and York have been honored for their commitments to patient safety by the Hospital and Health system Association of Pennsylvania, also known as HAP, as part of the inaugural class of HAP's Excellence in Patient Safety Recognition program.
And finally, some of our payer partners issued their own designation for exceptional quality and safety. And four of our hospitals were recently named Blue Distinction Centers in Maternity Care by Capital Blue Cross, including York, Gettysburg, Ephrata and Chambersburg hospitals. Each facility has demonstrated quality care, treatment expertise and better overall patient results.
Roxanna, these are many indicators that we're on the right track to ensuring high reliability, but these are just a few of the more recent affirmations.
Roxanna: Oh, that's great, Eugenia. There's a lot to be proud of, certainly. Personally, I'm also proud of the outcomes from our system-wide focus on reducing the number of opioids across our care locations. Since the spring of 2019, WellSpan teams have decreased the number of opioids ordered for patients by more than 1.8 million equivalent oxycodone pills. That's really incredible.
And we've also taken an active role in developing opioid treatment offerings for patients who've been diagnosed with opioid use disorder. This work stream's definitely a testament to the power of data and continuous improvement tools. So we're continuing to strive for high reliability in this area of opioid prescribing and in helping patients who have the opioid use disorder. Can you share with us an initiative that you think exemplifies the use of our lean tools in continuous improvement?
Eugenia Powell: Yes. The York Hospital team members made significant improvements in the management of patients with infections, specifically bloodstream and urinary tract infections. Similarly, improvements were also made in readmissions to the hospital within the 30-day time period. These improvements were a direct result of using lean principles in continuous improvement. Specifically, best practices and following clinical guidelines referred to as bundles were implemented. With that implementation, we were able to systematically improve our outcomes and bring value to the patient.
Roxanna: Oh, I'm really glad you highlighted that example out of York Hospital. And I also know that our team at WellSpan Chambersburg Hospital has been spreading its lean expertise and best practices to other facilities, so we're beginning to see the improvements take shape. So thanks to Chambersburg for that great work.
We've also covered a lot of ground here today, Eugenia. And as we try to give a call out to action to our listeners, something they can do as a takeaway from each episode, certainly, we all have a role to play in delivering safe, high quality care, especially our clinical teams, but is there something we can ask our team members to do in addition?
Eugenia Powell: Yes, Roxanna. Safety and quality belong to all team members. So our journey to high reliability and zero harm requires everyone's engagement. Team members can focus on Heads Up, Speak Up, which is our proactive program for recognizing and reporting potential safety concerns. Team members can also share our quality and safety success stories in their communities of family, friends, and neighbors. As you said, Roxanna, we have a lot to be proud of.
Roxanna: Yeah, that's a great note to close on. Eugenia. Thank you so much. And I hope our listeners will take that to heart. We can all be ambassadors for our healthcare organization within our circles of influence. Thanks for being with me today, Eugenia
Eugenia Powell: Thank you so much, Roxanna, for having me.
Roxanna: That's all the time we have for today. We hope you'll join us for the next episode of Inspiring Health.
Michael Carrese: You're listening to Inspiring Health with Dr. Roxanna Gapstur, President and CEO of WellSpan Health as she hosts candid conversations about organizational culture, value and other pressing issues we face in healthcare and business today, Roxanna. Tell me what we're going to be talking about today.
Roxanna: On this episode of Inspiring Health, we're picking up on a conversation that we began in episode two of the podcast about our journey to high reliability. Today, we're going to talk about identifying key metrics and quality and safety, also data-driven continuous improvement initiatives that have put us on the right track. And finally, we'll give a call to action regarding our Heads Up, Speak up program and invite our listeners to spread the word about our award-winning care.
Joining me today is Dr. Eugenia Powell. Eugenia is our Vice President of Patient Safety and Quality. She leads all patient safety and quality teams across the organization. Welcome, Eugenia. Thanks for joining me today.
Eugenia Powell: It's my pleasure to be here, Dr. Gapstur. Thanks for having me.
Roxanna: Oh, please call me Roxanna. So we started this conversation about high reliability with Mike Seim, our Chief Quality Officer last July. You joined our organization recently, Eugenia, in November and I wanted to start our conversation today the same way we did with Dr. Seim. What does high reliability mean to you, Eugenia?
Eugenia Powell: Well, Roxanna, high reliability means all patients can trust that we are providing the safest and most reliable care by reducing defects and errors. You know, patients come to us thinking they will not be harmed. As a highly reliable organization, our job is to recognize early warning signs of deviation or variation and take the appropriate actions. We are on a journey to zero harm. We can keep our patients safe by using the standard work lean strategies, tools, and principles that have been deployed at WellSpan.
Roxanna: That's great, Eugenia. You know, you're a nurse by trade, so how does your clinical experience inform your perspective about high reliability?
Eugenia Powell: Yes. As a nurse, delivering quality care and keeping patients safe and free from harm are the most important elements to care delivery. Very early in my career, I was a nurse leader in an organization where an infant was mistakenly administered more than three times the amount of the prescribed narcotic. You could only imagine, while that event did not occur in my clinical area, it still resonates for me today and has shaped my perspective on quality and safety.
As an industry, the bar has moved up over the years, but we're not there yet. The goal is zero harm. As nurses and as stated in our code of ethics, we have the duty to do no harm. We are human, so errors may occur, but that is why we strive for high reliability. A consistent proactive error reduction approach to care provision, injury and harm can be prevented.
As a nurse and as clinicians, we are obligated to provide safe care. All patients and families trust their loved one to us and it is our job to be competent, transparent, ethical, utilize best practice and stay in the mode of continuous learning.
Roxanna: I couldn't have said it better, Eugenia. I appreciate that perspective, having begun my career as a nurse as well. And it aligned so well with the organizational mantra that we have to establish high reliability. It's the right care at the right time in the right place. Consistency is key and is the minimum that our consumers should expect from us.
Now, we can track our progress using key metrics like safe opioid prescribing, or time and range for anticoagulants, patient experience scores, hospital-acquired infection rates, et cetera. These metrics are important and many of them are included in some of our national publicly reported quality measures like CMS and Leapfrog scores as well as our Medicare shared savings quality scores.
In fact, as we think about our move to value, many of these quality and safety metrics are also required by our payer partners. We know our patients and communities also have access to these measures online and they can compare WellSpan to other healthcare systems in our region. Eugenia, what's the value in some of these metrics like Leapfrog or CMS ratings to our consumers or community members?
Eugenia Powell: Well, Roxanna, Leapfrog is a national organization and it's one of many. It sets the toughest standards for healthcare quality and safety. Leapfrog assigns grades A to F to thousands of hospitals across the country twice a year. These grades are made available to consumers. Similarly, CMS assigns star ratings to hospitals across the country each year, like hotel ratings. Hospitals may receive a one star up to a five star, which is the best.
Organizations or groups like Leapfrog and CMS are informing healthcare decisions by putting the right information into a consumer's hand. It encourages consumer choice and it is needed because few resources exist to help consumers choose the best care.
Roxanna: So Eugenia, are all hospitals and medical groups the same when it comes to these publicly reported measures?
Eugenia Powell: No, I'm afraid not, Roxanna. All hospitals and medical groups are not the same. One of the benefits of groups such as Leapfrog and CMS is that consumers can get an idea for how different organizations compare on quality and safety. You know, I've worked in a number of healthcare organizations and I'm grateful to be part of the WellSpan team where it is clear that quality and safety across the system are the priorities for our work.
We just don't speak the language, but we identify and then take the necessary actions to improve. Our values, like find a better way and do the right thing, create the right foundation for us to think about quality and safety every day. And our lean management system gives us the tools to improve towards high reliability.
Roxanna: You know, that's a great segue, Eugenia, to talk about how we're differentiating ourselves at WellSpan. As part of our 2025 strategy, we've set out to achieve industry-leading safety and quality outcomes in our hospitals and medical practices. And recent indicators tell us we're on the right track. Can you share a few of those success stories with our listeners?
Eugenia Powell: Sure. These are success stories that we can all be really proud of. Our medical group has received a score of 96% on the most recent CMS Accountable Care Organization quality metrics. This tells us that we perform at a very high level across our medical group when it comes to quality and safety. We've also just recently learned both Ephrata and Chambersburg hospital received five star ratings from CMS. Five star ratings, Roxanna. Waynesboro, Gettysburg, Good Samaritan, York hospitals, all received four stars. The star ratings include more than 57 measures of both quality and safety for hospitals. We're very proud of that.
When it comes to our most recent Leapfrog safety scores, the Chambersburg and Waynesboro hospitals were both named 2020 Leapfrog Top Teaching Small Hospitals. This is the first time a WellSpan Hospital has received a top hospital award from Leapfrog. In addition to receiving that award, Chambersburg, Ephrata, Gettysburg and York Hospitals, all earned A safety grades from Leapfrog.
Another success story is that we were recently honored with 12 American Heart Association, American Stroke Association Get With The Guidelines awards at six of our acute care community hospitals for achievements in stroke and heart-related care. Chambersburg, Ephrata and York have been honored for their commitments to patient safety by the Hospital and Health system Association of Pennsylvania, also known as HAP, as part of the inaugural class of HAP's Excellence in Patient Safety Recognition program.
And finally, some of our payer partners issued their own designation for exceptional quality and safety. And four of our hospitals were recently named Blue Distinction Centers in Maternity Care by Capital Blue Cross, including York, Gettysburg, Ephrata and Chambersburg hospitals. Each facility has demonstrated quality care, treatment expertise and better overall patient results.
Roxanna, these are many indicators that we're on the right track to ensuring high reliability, but these are just a few of the more recent affirmations.
Roxanna: Oh, that's great, Eugenia. There's a lot to be proud of, certainly. Personally, I'm also proud of the outcomes from our system-wide focus on reducing the number of opioids across our care locations. Since the spring of 2019, WellSpan teams have decreased the number of opioids ordered for patients by more than 1.8 million equivalent oxycodone pills. That's really incredible.
And we've also taken an active role in developing opioid treatment offerings for patients who've been diagnosed with opioid use disorder. This work stream's definitely a testament to the power of data and continuous improvement tools. So we're continuing to strive for high reliability in this area of opioid prescribing and in helping patients who have the opioid use disorder. Can you share with us an initiative that you think exemplifies the use of our lean tools in continuous improvement?
Eugenia Powell: Yes. The York Hospital team members made significant improvements in the management of patients with infections, specifically bloodstream and urinary tract infections. Similarly, improvements were also made in readmissions to the hospital within the 30-day time period. These improvements were a direct result of using lean principles in continuous improvement. Specifically, best practices and following clinical guidelines referred to as bundles were implemented. With that implementation, we were able to systematically improve our outcomes and bring value to the patient.
Roxanna: Oh, I'm really glad you highlighted that example out of York Hospital. And I also know that our team at WellSpan Chambersburg Hospital has been spreading its lean expertise and best practices to other facilities, so we're beginning to see the improvements take shape. So thanks to Chambersburg for that great work.
We've also covered a lot of ground here today, Eugenia. And as we try to give a call out to action to our listeners, something they can do as a takeaway from each episode, certainly, we all have a role to play in delivering safe, high quality care, especially our clinical teams, but is there something we can ask our team members to do in addition?
Eugenia Powell: Yes, Roxanna. Safety and quality belong to all team members. So our journey to high reliability and zero harm requires everyone's engagement. Team members can focus on Heads Up, Speak Up, which is our proactive program for recognizing and reporting potential safety concerns. Team members can also share our quality and safety success stories in their communities of family, friends, and neighbors. As you said, Roxanna, we have a lot to be proud of.
Roxanna: Yeah, that's a great note to close on. Eugenia. Thank you so much. And I hope our listeners will take that to heart. We can all be ambassadors for our healthcare organization within our circles of influence. Thanks for being with me today, Eugenia
Eugenia Powell: Thank you so much, Roxanna, for having me.
Roxanna: That's all the time we have for today. We hope you'll join us for the next episode of Inspiring Health.