The rising cost of health care affects nearly everyone today. In fact, here in the U.S., people spend more money per capita on health care than any other developed country. And yet, it is a widely held view that the American health care system does not perform nearly as well as it should or could.

The efforts to improve the quality, efficiency and effectiveness of health care must occur at multiple levels. Here at Memorial, the management team has directed its efforts to ensure that core values are considered in each case where treatment or care of any kind is administered. We strive continuously to provide quality care in a safe, effective, patient-centered environment, while providing timely, efficient and equitable services.

Technology & Patient Safety

• Safe means patients will not be harmed by the care that is intended to help them.
• Effective means care will be based on scientific knowledge and applied in the best possible manner to ensure a good outcome.
• Patient-centered means care will be respectful of and responsive to individual patient preferences, needs and values.
• Timely means efforts will be directed to reduce waiting times and delays.
• Efficient means care will be given without wasting equipment, supplies, ideas and energy.
• Equitable means care will not vary in quality because of personal characteristics such as gender, ethnicity and socio-economic status.

Memorial is accredited by The Joint Commission, an independent, not-for-profit organization which awards accreditation to institutions that are willing to prove that they meet safety and quality standards for health care. It is vital that health care consumers know the hospital they choose is an advocate and defender of quality community health care . In order to reassure consumers and continually improve quality, Memorial actively seeks out objective reporting and feedback that will help us assess our performance and increase our level of care. Through an adherence to strict quality measures we are able to demonstrate our commitment to Appropriate Care Measures.

In addition, we maintain the quality and safety of the medical care we provide through our on-site rapid response team, inpatient diabetes management and our surgical site infection prevention activities.

What is The Joint Commission and what does it mean to you?

As part of our commitment, Memorial has been evaluated by survey teams from The Joint Commission. We were the first hospital in the state, and one of the first in the nation, to be tested with an exciting, new unannounced survey process.

The “patient tracer” system allows independent surveyors to follow actual patients through their hospital stay to see the hospital experience through the patient’s eyes. The team randomly selects patients and scores the hospital on the safety and quality of care those patients received. At the same time, the survey team takes the opportunity to report on general systems and procedures. This real-time assessment, with real patients, gives surveyors pertinent information because a specific patient’s experience can show how consistently Memorial responds across a variety of departments

Hospital accreditation is totally voluntary. Memorial welcomes the opportunity to be surveyed in order to get the best information about how patients experience care.

Appropriate Care Measures

The Appropriate Care Measures (ACM) policy is a composite measure of the 10 core measures defined by the Medicare Modernization Act (MMA) and used by the Hospital Quality Alliance (HQA) for public reporting. The ACM is patient-centered and designed to answer the question: “Did the patient receive all the care he or she should have received, based upon his or her clinical condition?” Teams focus on reducing the gap between the care the patient should have received and the care the patient did receive.

Quality measures

The ACM is based on the publicly reported quality indicators for the following clinical conditions:

• Heart atttack--asprin at arrival, aspirin at discharge.
• Heart failure (HF)--heart function assessment and specific heart protective medication at arrival, during hospitalization and at discharge.
• Pneumonia (PN)--antibiotics received within four hours of arrival, oxygenation assessment and pneumoccoccal vaccination.

Memorial’s surgical site infection prevention activities

The purpose of Memorial’s Surgical Infection Prevention (SIP) collaborative is to improve the quality of care delivered to patients during surgery in a cost-effective manner using proven, evidence-based practices. The goal is for 100 percent of eligible patients to receive appropriate and timely prophylactic antibiotics.

Surgical Infection Provention is the first generation of tracking surgical infections at Memorial. The procedures tracked in SIP are hip, knee, colon, vascular and hysterectomy surgeries.

Surgical Care Improvement Project (SCIP) is the second generation of tracking surgical infections and is part of a national quality partnership that has set a goal to reduce the rate of national surgical complications by 25 percent by 2010.

Of the more than 42 million surgeries performed in the U.S. each year, up to 40 percent have associated postoperative complications such as infection, thromboembolic events, respiratory complications and adverse cardiac events, according to the Health Services Advisory Group. These complications take a toll not only on the patients, but also on the overall cost of health care—increasing length of stay and hospital costs. At Memorial, we know that a significant percentage of these complications are preventable, and we are committed to quality and safety measures that help us achieve these goals, ultimately providing our patients with better care.

Rapid response team

Memorial instituted a rapid response team (RRT) in March 2006. The RRT is a support team offered to the patients and staff of Memorial when there are signs that a patient’s health is declining.

Members of the RRT include the patient’s primary nurse, a critical care nurse, a respiratory therapist, the nursing supervisor and a pharmacist. They are available by pager to immediately assist at the bedside of any patient upon request of the primary nurse. The goal of the RRT is to intervene early when a patient shows signs of a deteriorating condition.

The RRT uses the communication technique SBAR to ensure concise, complete information is given to the primary physician. SBAR is short for Situation, Background, Assessment and Recommendation.

Managing diabetes in the hospital:
Impact on morbidity, mortality and length of stay

More than 20 million Americans have been diagnosed with diabetes, and according to the American Medical Association, one out of every 10 health care dollars spent in the U.S. is attributable to diabetes. The inpatient costs of diabetes have doubled in the past 10 years, and are now approaching $40 billion per year. The clinical consequences of uncontrolled hyperglycemia in hospitalized patients include:

• Increased bloodstream infections.
• Prolonged inflammation.
• Renal failure.
• Polyneuropathy (nerve inflammation that results in loss of movement or sensation).
• Increased transfusion requirements.
• Cardiovascular events.
• Poor surgical wound healing.

With more attention to identifying diabetes and hyperglycemia in the hospitalized patient, and by carefully and thoughtfully pursuing improved control of glucose, we can prevent complications, improve patient outcomes and reduce unnecessary hospital days and hospital costs.

For more information about Memorial’s Diabetes Education programs, please click here.

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