Focus on Excellence awards program challenges physicians, nurses and staff to be health care innovators

At the 2014 Focus on Excellence Awards, keynote speaker Raymond J. Fabius, M.D., argues that to improve health care systems now, we must form population health management organizations driven by value rather than volume, and motivated by both penalties and incentives provided by rollout of new federal laws.

February 16, 2014

The annual Focus on Excellence Awards program at Christiana Care is like a health care Olympics. Elite teams compete to win laurels for quality, merit, innovation and best results. But while Olympians compete for the glory of their countries, the physicians, nurses and staff at Christiana Care aim to transform health care in ways that benefit our patients and community.

For more than a decade, an annual awards program has challenged everyone who works at Christiana Care — some 10,000 in all — to be health care innovators. Each year, in a continual cycle, they form teams and find ways to improve what we do, and then compete for recognition as one of the best.
Now known as the Focus on Excellence awards, the program began in 2003 as the Performance Improvement Awards. There were 53 submissions that year vying for 11 trophies in four award categories: President’s, Pacesetters, Achievers and People’s Choice awards.

The President’s Award recognized a team of 25 from the Department of Medicine, the Ammon Diabetes Prevention and Care Project, for “Improving Glycemic Control in the Adult Medicine Office,” a concerted, successful effort to improve uncontrolled diabetes among patients of the Adult Medicine Office.

This year, the program received 144 entries. The coveted President’s Award went to a project titled “Improving Glycemic Control in the Adult Medicine Office.” Uncontrolled diabetes is a population health scourge that leads to many devastating, costly health complications.

A multidisciplinary team of physicians, nurses and adult-diabetes educators developed and implemented a comprehensive diabetes disease management program to meet the needs of a defined adult diabetic population under the care of Christiana Care’s Adult Medicine Office. The primary goal was to increase the number of patients whose diabetes was under control from 63 percent to about 70 percent in fiscal year 2013. Thanks to this team’s determination, more than 25 percent of active diabetic patients with poorly controlled diabetes achieved control, and the overall rate of glycemic control increased to 70.8 percent.

The Operation Improvement Silver Award went to “Virtual Server Infrastructure,” an Information Services-led team project that saved Christiana Care an estimated $13 million by finding innovative ways to conserve on the costs of new and replacement computers while enhancing data recovery services and the overall data-center footprint.

“Without question, your commitment, creativity and fine work are transforming the way we provide care to our patients and are adding value to the services we offer them,” said Robert J. Laskowski, M.D., MBA, Christiana Care president and CEO, recognizing the high caliber of all of this year’s entries.
This year’s awards also introduced a new category designed by Christiana Care’s Value Institute to identify projects with the greatest research potential. Four award winners are now teamed with a Value Institute researcher for possible expansion of their projects.

Julia Turner, RN on Patient Care Unit 5A, was a one of three nurses recognized for making a “good catch” in time to help prevent patient harm. Observing that her patient was at risk for sepsis, she notified the attending physician and called the Rapid Response Team. Other Good Catch honorees included Jody Fennell, RN, VNA case management supervisor, and Karen Mazei, RN, NICU.

“The Value Institute, which is comprised of diverse expertise (medicine, public health, sociology, law, economics and mathematics), applies research methods to vexing clinical conundrums that ultimately provide clinicians and administrators with data to support optimal decisions about patient care,” said Eric V. Jackson, M.D., MBA, associate director of the Value Institute and director of the Value Institute’s Center for Health Care Delivery Science.
The President’s, Nursing Excellence and People’s Choice awards still remain after 11 years, but many of the 39 awards issued in January 2014 reflect such areas as value, safety, education, community health, research and clinical excellence.

“The quantity and diversity of the submissions have always adjusted to Christiana Care’s annual goals and operating plans, and the constant changes and improvements inspire innovation and cooperation,” said Sharon Anderson, RN, BSN, MS, FACHE, senior vice president, Quality, Patient Safety & Population Health Management, and director, Value Institute Center for Quality & Patient Safety.

As participation in the awards has grown, so have opportunities to recognize excellence.

“With the increasing number of very high quality entries across so many areas of the health system, we wanted to make sure we recognized as many as possible, so we created more categorical awards with gold, silver, bronze or honorable mention awards,” said Donna Mahoney, MHCDS, director of Data Acquisition and Measurement. “There also is a special award now, the Good Catch All Star award, for staff members who distinguish themselves in taking corrective action to eliminate potential harm to a patient, visitor or staff.”

General guidelines for the Focus on Excellence Awards have remained constant. Teams are encouraged to identify an opportunity for improvement, then develop and carry out a plan to achieve improvements in process or outcomes using the Plan-Do-Check-Act model. Teams create a storyboard that explains the project, and all of the storyboards are displayed in an exhibit in October, in conjunction with National Healthcare Quality Week. The storyboards also are viewable online internally throughout the health system.

More than 149 colleagues volunteered as judges for the 2013 crop of entries. The program culminates each year in an awards celebration that features a nationally known guest speaker, the awards ceremony and a reception.

The Christiana Care Way

Dr. Laskowski remarked that this year’s awards exemplified The Christiana Way.

“The Christiana Care Way is our promise to serve our neighbors as respectful, expert, caring partners in their health,” he said. “We do this by creating innovative, effective, affordable systems of care that our neighbors value.”

The keynote speaker at this year’s celebration was Raymond J. Fabius, M.D., CPE, FACPE, founder of HealthNEXT, a Phildelphia-based company dedicated to the development of organizational cultures of health. Dr. Fabius lectured on the need to form population health management organizations driven by value rather than volume and motivated by both penalties and incentives provided by rollout of new federal laws.

Fabius also cited research showing that health care workers are generally in poorer health than the average member of the nation’s work force.
“After improving the health of your workforce, you will be better able to do the same for others,” he said.

Magnet impact

Ever since Christiana Care received Magnet designation, the Nursing Awards category has modeled its selection of winners on six Magnet model components, the first of which is Transformational Leadership.

“Highway to the Surgical Critical Care Unit: Decreasing Emergency Department Length of Stay for Trauma Codes” was a collaboration by staff from the Trauma program, the Surgical Critical Care Complex and the Emergency Department at Christiana Hospital. The project helped streamline the transportation process and cut the amount of time that patients have to stay in the ED, with a reduction in average ED length of stay of more than 90 minutes. The project also significantly reduced average length of stay in intensive care and overall hospital stay.

The improvements resulted in a direct variable cost savings of $278,000.