ABSTRACT
BACKGROUND: Through an innovative affiliation, Duke University Health System (DUHS), a large and complex academic health system, and LifePoint Health® (LifePoint [LP]) collaborated to create a joint venture, DLP Healthcare (DLP) to measurably improve culture and quality and patient safety metrics in community hospitals across the United States. A structured approach to quality was developed in DLP hospitals and later refined and spread to all LP hospitals through the National Quality Program (NQP). METHODS: The NQP was designed to drive organizationwide performance improvement through use of a framework of leadership, performance improvement, and culture. A comprehensive quality assessment of each DLP and LP hospital led to the creation of a customized improvement plan that was specific to the performance level of individual hospitals and aligned with strategic organizational goals. The improvement process was data driven, managed with defined improvement methodologies and practices, and implemented in a culture that honors teamwork, mutual respect, accountability and provider well-being. RESULTS: Implementation of the NQP has led to significant improvements in patient safety metrics and in safety culture, which have now been sustained for more than seven years. Aggregate harm, as measured by administrative claims data-based harms per 1,000 inpatient-days, was reduced by 62.5% between January 2011 and December 2017, as compared to 2010 baseline data. CONCLUSION: The LP and Duke journey to achieve high reliability in community hospitals has yielded significant improvement in measures of patient safety and culture. The results are consistent with literature supporting the link between culture and overall performance.
Subject(s)
Hospitals, Community/organization & administration , Organizational Culture , Patient Safety/standards , Quality Improvement/organization & administration , Safety Management/organization & administration , Accidental Falls/prevention & control , Benchmarking/methods , Benchmarking/standards , Hospitals, Community/standards , Humans , Iatrogenic Disease/prevention & control , Program Development , Program Evaluation , Quality Improvement/standards , Quality Indicators, Health Care/standards , Safety Management/standards , Systems Integration , United StatesABSTRACT
As the healthcare environment continues to evolve, many community hospitals of all sizes are finding it difficult to thrive and grow in the headwinds of increasing regulatory requirements, decreased reimbursements amidst healthcare reform efforts, increased requirements for efficiency, demands for improvement in the patient experience, and increasing penalties for lagging performance in patient safety and quality metrics. A unique partnership, involving an organization built upon expertise in operating community hospitals and an academic center with expertise in patient safety, quality, innovation, and care delivery, has provided a successful solution for a growing number of challenged community facilities. The purpose of this article is to demonstrate how using standardized patient safety, quality improvement processes, and high-reliability strategies in community hospitals has been supported and enhanced through the development of a healthcare affiliation network with an academic medical center. By developing this type of quality affiliation, hospitals across a broad spectrum of sizes and locations can achieve significant improvement in safety culture while demonstrating measureable advances in quality and safety and supporting their mission of "making communities healthier, together."
