The annual Focus on Excellence Awards program is all about the benefits and advantages of healthy competition within Christiana Care Health System to advance The Christiana Care Way.
This year’s winning projects — culled from 146 projects, submitted for a two-week exhibition in October 2014, represent the best efforts at improvement and successes achieved at Christiana Care during the past year.
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Based on scores provided by approximately 150 expert judges who volunteer each year, the prevailing teams announced Jan. 20 were honored with laurels for quality, merit, innovation and best results, at a packed John H. Ammon Medical Education Center.
“The quality of the work just keeps getting better and better, and reflects our understanding as an organization of what it means to live The Christiana Care Way … helping our neighbors live the lives they want to live and doing it in ways that are affordable, safe and valuable,” said Janice Nevin, M.D., MPH, Christiana Care president and CEO. She said that the awards exemplify the concept of innovation in creating value for patients and their families.
Sharon Anderson, MS, BSN, RN, FACHE, senior vice president, Quality, Patient Safety & Population Health Management, and director, Value Institute Center for Quality & Patient Safety, master of ceremonies, thanked the Focus on Excellence Program team for their efforts throughout the year and the more than 35 volunteers involved in the program for their hard work in making it a success.
“Today we celebrate the end of another year of Focus on Excellence competition by announcing the winning entries,” Anderson said. “Yet every project entry, whether it wins or not, represents the spirit of the Focus on Excellence Awards and our determination to advance The Christiana Care Way. 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.”
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.
This year, the President’s Award, presented by Dr. Nevin, is titled “The Brown Battle, Reduction of WICU Acquired Clostridium Difficile Rates.”
Clostridium difficile (C. diff) is recognized as the most common cause of nosocomial infectious diarrhea. According to the National Institutes of Health, the morbidity and mortality associated with C. diff is increasing at an alarming rate, especially among the critically ill. After identifying an increasing incidence of hospital-acquired C. diff, this team went on the offensive, introducing the “WICU C. diff Bundle.” The bundle includes: environmental monitoring with swabbing; improving staff awareness of C. diff and swabbing results; hand hygiene, antibiotic stewardship and stop dates, and proton pump inhibitor stewardship.
Achievements noted include environmental monitoring results of “safe” for all swabbed items, 95 percent hand hygiene compliance, 29 percent reduction in antibiotics and a 22 percent reduction in dispensed PPI. WICU has had no cases of C. diff since implementing the bundle in March 2014.
Bolstering the Focus on Excellence clearly observed in the President’s Award winning entry are two awards that also recognize success in keeping patients from harm, proactively and through preventive efforts: the new Zero Patient Harm award and the Good Catch awards.
The Zero Patient Harm program tracks Christiana Care’s progress in achieving the annual operating plan goal to reduce central-line-associated bloodstream infections, catheter-associated urinary-tract infections, C.diff, surgical-site infections after colon surgery and abdominal hysterectomy, injuries to patients from falls and other harmful events. To-date, 35 Zero Harm Awards have been issued.
The Good Catch All Star Program encourages staff to take action to correct a situation that has the potential to harm a patient, visitor or staff. More than 8,500 Good Catches have been submitted since the program launched in March 2012. This year, No. 1 Good Catch recognition went to two nurses in the GI Lab at Christiana Hospital who recognized that a patient was not recovering well from anesthesia after same-day surgery, resulting in the patient’s admission to intensive care. Another Good Catch honoree was Bruce Harper, a service assistant on 6E, who alerted the nursing team when a patient fell silent during a conversation. The patient received urgent intervention from respiratory therapy thanks to Harper’s caring response.
Innovation in Behavioral Health
Under the “Excellence in Community Health Category,” the Focus on Excellence Gold Award went to the team at the Rocco A. Abessinio Family Wilmington Health Center for its entry, “Integration of Behavioral Health in Primary Care.”
The team proposed hiring an expert in behavioral health psychology to help identify indications for consultation and be available onsite to take patient handoffs at the Adult Medicine Office and the Internal Medicine Faculty Practice. Over a nine-month period the expert also developed and administered surveys to identify patient characteristics and social needs, and began implementation of multidisciplinary group skill development sessions.
Chief Medical Officer Kenneth Silverstein, M.D., MBA, praised the program and recently announced a new model at Wilmington campus primary care offices, wherein adult and adolescent outpatient behavioral health service providers will work more closely with the community’s primary care network. Therapists are embedding directly within primary care practices. Services are expanding and behavioral health clinical staff is increasing. The transformation is the result of a study that identified a significant need to address patients with medical conditions that are adversely impacted by social determinants of health, as well as a substantial burden of treating chronic mental health conditions.
Results indicate very high satisfaction by both patients and providers with an embedded psychologist in primary care. Importantly, a very large number of patients reported that they would not have received care if it were not offered in that setting.
This year’s list of Focus on Excellence Awards ceremony featured awards from across Christiana Care Health System, including awards for excellence in:
- Diversity, Inclusion & Cultural Competency.
- Residency Training.
- Excellence in Community Health (Gold, Silver, Bronze).
- Operational Improvement (Silver, Gold).
- Learning Excellence.
- Nursing (Six categories with more than 10 awards).
- Financial Strength.
- Think of Yourself As a Patient (Honorable Mention, Bronze, Silver, Gold).
- Great Place to Work (which also garnered the People’s Choice Award).
- Employee Safety.
- Safety First (Silver, Gold).
- Clinical Excellence (Honorable Mention, Bronze, Silver, Gold).