St. Luke’s Hospital & Health Network in Bethlehem, Pa., has leveraged its participation in three different quality initiatives to improve the quality of healthcare delivery.
The health system follows Baldrige criteria for organizational excellence in its four hospitals and numerous outpatient sites. St. Luke’s 43,972 annual admissions and 2,345 observations yield net revenue of $848.1 million.
“We are very concerned about healthcare quality, safety and cost,” said Donna Sabol, MSN, RN, chief quality officer at St. Luke’s.
The health system’s push toward quality started with Premier’s Hospital Quality Incentive Demonstration (HQID), a pay-for-performance initiative.
“We knew it was a good thing to do and we knew it was risk-taking because it was the first time our performance data was going to be published and made transparent, but we didn’t know how well it would prepare us for healthcare reform and how much we would learn,” said Sabol.
A second Premier project, the QUEST initiative, broadened the dimensions of quality measurement and highlighted the areas St. Luke’s needed to improve, officials said. This past spring, the newest Premier initiative, the Accountable Care Organization Readiness Collaborative, is helping St. Luke’s get ready to apply to become an Accountable Care Organization in 2011.
“We know our participation has really helped us be prepared for that,” said Sabol.
St. Luke’s officials believe it is important to get leadership and medical staff engaged in all of the initiatives.
“Quality is probably the most important priority of the organization,” said Richard Anderson, the system’s president and CEO.
St. Luke’s network includes 1,158 licensed physicians, so getting them to buy into the quality initiatives was important. Joe Merola, MD, chairman of obstetrics and gynecology, said the health system designated physicians with “preferred” provider status to get them to buy into the quality initiatives.
St. Luke’s found that assigning leadership positions in departments, divisions and sections helped staff feel involved. Designating physician champions for quality and safety change agendas was another effective method.
“We also have a ‘practice building guarantee’ or two that we use each year,” said Merola. “It pays people for various educational jobs – a very good hook for people on the private side that we can bring into the fold.”
Merola said St. Luke’s communicates expectations very clearly at every level.
“We have leadership in quality and this is translated all the way down,” he said. “As a result, we have a collective spirit and good will and can retain people who work in this area.”
Health system officials say they do fear “dis-employment” of doctors while quality measures are implemented, as well as problems assigning responsibility for measures. There’s always a possibility of withdrawal of support, remuneration and negative profiling.
As evidence of its overall quality improvement, the health system points out a few of its achievements:
9th best mortality rate among 165 hospitals participating in Premier Quest Demonstration Program between the third quarter of 2008 and the second quarter of 2009;
Among top 10 Level I trauma centers in America for quality as measured by mortality rates (American College of Surgeons’ Committee on Trauma, 2009 Report);
Performance better than other hospitals in the region in public data reports (Thomson Reuters, HealthGrades, PHC4, U.S. News & World Report);