A Historical Overview of Quality Initiatives at SwedishAmerican
Quest for Quality and Productivity in Health Care seminar investigated the applications of CQI and TQM as they relate to health care.
Consultation on quality with Juran Institute. An executive dialogue with senior management to acquaint the consultant with the present quality management efforts, quality procedures, policies, etc., and to allow him an understanding of the organization's priorities for future quality efforts.
Making Quality Happen seminar was the first step in the development of a Total Quality Management program at SwedishAmerican Hospital. Juran gave an overview and a general course of action was set.
A Quality Council was formed.
A meeting was held to formalize a strategic plan for implementation of TQM at SwedishAmerican.
Pilot Team Training sessions were conducted by the Juran Institute, to provide an overview of TQM and train team members in the areas of group dynamics, tools, and team processes.
Quality Project Team began meeting to monitor costs and charges.
Quality Project Team began meeting to shorten admission time from Emergency Department. Mission: To reduce admission time (once admit order is given) from the ED to the nursing units by 50%.
Facilitator Training. Purpose: To gain the knowledge and skills necessary to become a team facilitator. Staff sent to Wilton, Connecticut, to learn skills.
Consultative visit with Juran Institute. Purpose: To assess the progress of the three pilot teams and the TQM program in general. Summary recommendations to the Council included:
- Adding outcomes to projects
- A process for Council to approve projects
- Use of various data by the Quality Council
- A second wave of projects
- Ranking of projects
- Overlapping data
- Time frame for completion of projects
Quality Project Team began meeting to reduce blood gas turnaround time between lab and ICU/CCU. (RIT/USA Today Quality Award Winner)
Project Teams Facilitator Training (also in March, 1992). Purpose: To gain the knowledge and skills necessary to become a project team facilitator.
Consultative Visit. Purpose: To assess the progress of TQM after one year, to introduce TQM to vital members of the medical staff, and to review current team activity.
Tools Training (also took place in August, 1991). Purpose: To obtain information on using a variety of quality improvement tools useful to completing TQM projects.
Quality Project Team began meeting to reduce turnaround time between Emergency Department and Lab. Mission: To reduce turnaround time for lab tests by 35% from the point of physician order to getting the results on the chart in the ED. (RIT/USA Today Quality Award Winner)
Quality Project Team began meeting to increase available productive OR time. Mission: To decrease gap time in OR lines by 20%.
Team Training. Purpose: Two day workshop with Juran Institute to train new team members in team dynamics and the basics of TQM. This was the last team training session conducted by an outside consultant. From this point on, SwedishAmerican's trained facilitators took responsibility for team training.
Quality Project Team began meeting to reduce number and cost of lost patient valuables. Mission: To reduce the incidence of lost or damaged personal effects by 50%.
Quest for Quality and Productivity in Health Care. Purpose: To investigate the applications of CQI and TQM as they relate to the delivery of health care services.
IMPRO '91. A TQM conference sponsored by the Juran Institute in which over 60 speakers took part. Workshops focused on the practical application of TQM, and opportunities for networking were numerous.
Total Quality in Health Care: Making It Happen! Purpose: To assess the possibilities for and application of TQM strategies in health care as they relate to:
- Cultural change
- JCAHO standards
- Critical pathways
- Purchasers' needs
Team Training (also in July, 1992). Purpose: To give an overview of TQM and train team members in the areas of group dynamics, tools, and team processes.
Quality Project Team began meeting to increase the availability of wheelchairs.
Quality Planning Teams Facilitator Training. Purpose: To gain the knowledge and skills necessary to become a planning team facilitator.
Planning for Quality Seminar. Purpose: This seminar, held at the Juran Institute, was for the purpose of acquainting participants with quality planning as it affects both departmental and company-wide missions. To give a deeper understanding of quality planning, thereby contributing to the organization's overall approach to planning.
Quality Project Team began meeting to determine the best process to use in expediting EKG reports to physicians and other members of the clinical staff.
Management Training. Two days devoted to teaching concepts.
During this month, the first of many Clinical Pathways began at SwedishAmerican. The goals of all Clinical Pathways are to:
Open Heart Surgery Clinical Pathway launch. Mission: Reference the Clinical Pathway goals listed above.
- Provide a mechanism for evaluating and improving quality.
- Standardize resource use.
- Incorporate expert knowledge and practice patterns of multidisciplinary clinicians.
- Improve continuity of care by delineating responsibility and accountability of all caregivers.
- Promote proactive, cost-effective, and efficient care.
- Encourage active patient and family participation, compliance, and accountability in the clinical course and outcome.
- Provide for objective identification, documentation, and analysis of outcomes.
Quality Project Team began meeting to improve inpatient/outpatient scheduling. Mission: To improve inpatient scheduling and coordinate with the outpatient scheduling system.
Quality Project Team began meeting to increase the therapeutic range of antibiotics. Mission: To increase the percentage of patients that become therapeutic from 71% to 90%, and to increase the percentage of patients that become therapeutic within the first regime of treatment from 51% to 75%.
Management Training (also in September, October, November 1992 and July 1993).
Consultative Visit by Juran Institute.
Midwest Business Group on Health, "Improving Quality to Reduce Costs." Purpose: To consider initiatives for improving quality to reduce costs through employer-provider value improvement partnerships. To investigate quality improvement projects sponsored by coalitions across the country that demonstrate the importance of such partnerships.
Project Teams Facilitator Training.
Quality Project Team began meeting to monitor venous access devices.
Quality Project Team began meeting to reduce the number of patient falls. Mission: To reduce patient falls on 7 East, 8 East, and 4 East.
Facilitation Skills for Quality Improvement. Purpose: An advanced course in group facilitation, designed to improve knowledge and further develop the skills necessary to maximize group effectiveness in a quality management environment.
Quality Planning Teams Facilitator Training.
Consultative Visit with Juran Institute.
SwedishAmerican was named National Award Winner in RIT/USA Today Quality Cup Competition.
First Meeting of the TQM team to review duplicate medical records.
Laparoscopic cholecystectomy Clinical Pathway launch. Mission: Reference the Clinical Pathway goals listed under July 1992.
Chemotherapy Clinical Pathway launch. Mission: Reference the Clinical Pathway goals listed under July 1992.
Clinical Pathway for normal newborn (vaginal delivery) plan of care launch. Mission: Reference the Clinical Pathway goals listed under July, 1992.
Clinical Pathway for total hip replacement launch. Mission: Reference the Clinical Pathway goals listed under July 1992.
Clinical Pathway for total knee replacement launch. Mission: Reference the Clinical Pathways goals listed under July 1992.
SwedishAmerican selected as national finalist in RIT/USA Today Quality Cup Competition.
Environmental rounds TQM team launch. Mission: To develop an integrated approach to the assessment, education, and improvement of the environment in which employees provide care to patients.
Late tray TQM team launch. Mission: To improve communication, decrease the amount of late trays by 50%, thus improving customer satisfaction and minimizing expense.
MSDS TQM team launch. Mission: To re-design and implement a functional MSDS file system.
Emergency Department chest pain Clinical Pathway launch. Mission: To provide a systematic approach to patients presenting chest pain of cardiac origin, so that definitive interventions may be initiated within a 45-minute period of time.
Pharmacy STAT TAT TQM team launch. Mission: To reduce the average time from order entry to administration for STAT medications to 30 minutes.
Latex TQM team launch. Mission: To develop protocols for the identification and safe care of patients who are at risk for latex sensitization or latex allergy.
SwedishAmerican is named one of the top ten best-networked hospitals in North America by Health Care Informatics Magazine.
Angioplasty Clinical Pathway launch. Mission: Reference the Clinical Pathway goals listed under July 1992.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) awards "Accreditation With Commendation."
Quality team to review drug/food interaction launch. Mission: To improve patient education for drug/food interaction.
SSA/OR TQM team launch. Mission: To reduce costs and improve efficiency of furnishing supplies for the operating room. Also to establish clear responsibilities and communication between work groups.
HIV/AIDS Clinical Pathway launch. Mission: To increase the coordination of inpatient and outpatient care, as well as support services for the northern Illinois HIV/AIDS population.
Cardiac intervention Clinical Pathway launch. Mission: Reference the Clinical Pathway goals listed under July 1992.
Blue Cross/Blue Shield Association selected SwedishAmerican's Children's Cancer Center for their national Pediatric Cancer Care Network.
ED Acute Myocardial Infarction Clinical Pathway launch. Mission: Reference the Clinical Pathway goals listed under July 1992.
Benchmark launches asthma and diabetes disease management programs.
Quality team begins meeting to reduce the occurrence of sharps injuries.
SwedishAmerican is selected as a finalist for HCFA National Centers of Excellence demonstration projects in cardiology and orthopaedics.
First Annual Quality Expo - An event for key business decision makers highlighted Swedish-American's cutting-edge technology, prevention/wellness initiatives, and quality processes.
Central supply TQM Team begins. Mission: To improve overall communication and efficiencies between the nursing units and central supply by developing standardized policies and procedures resulting in quality patient care.
Express Admission Unit opens. Purpose: To improve patient satisfaction and reduce duplication of admission processes.
Cerebrovascular accident Pathway launch. Mission: Reference the Clinical Pathway goals listed under July1992.
SwedishAmerican receives Gold Award from the National Worksite Wellness Council of America.
Level II nursery/lab services TQM team launch. Mission: To improve the turnaround time of test results from the lab to the nursery.
MIS "SWAT" team launch. Mission: To standardize registration compliance among practitioners.
SwedishAmerican is selected as national finalist in RIT/USA Today Quality Cup Competition.
Second Annual Quality Expo - An event for key business decision makers highlighting SwedishAmerican's cutting-edge technology, prevention/wellness initiatives, and quality processes.
Benchmark launches congestive heart failure disease management program.
Benchmark launches a comprehensive maternity wellness program, Future Footprints, designed to help reduce the risk of an early delivery.
SwedishAmerican Medical Group launches a customer service program at Brookside to enhance a positive customer focused culture.
Acute heart failure Pathway launch. Implementation of this pathway began, along with protocol orders for patients with heart failure.
TQM Facilitators revise their original (1993) TQM teaching manual titled, "Quality Begins With You." Distribution is accomplished throughout the organization.
SAH Home Health begins a "Continuity of Care" TQM team so that patients see four or fewer different nurses during their stay.
SAH hosts JCAHO survey, which results in complete and successful accreditation for next three years.
SAH Chronic Obstructive Pulmonary Disease (COPD) Clinical Pathway begins.
MSO begins "Telephone Access TQM" team to reduce average telephone hold time.
SAH begins Pediatric Asthma Clinical Pathway to reduce high readmission rates and frequent ED visits for patients.
Quality Expo hosted for public and business community.
SAH submits 50-page application to Lincoln Foundation in quest for assessment and feedback on business excellence.
SAH team begins creation of clinical pathway team for managing patients who have diabetes and are to have surgery called Perioperative Diabetic Protocol.
SAH team begins creation of clinical pathway for provision of care for patients who go through alcohol withdrawal while hospitalized.
SwedishAmerican begins development of "Comfort Care Program" to identify and serve the population of patients who need end-of-life care. This program provides for addressing spiritual, emotional and physical care needs of patients and families. SAH is only hospital offering this in Rockford.
American Diabetic Association awards SAH the Education Recognition Certificate for a quality diabetic self-management program.
SAH is awarded the highest (level III) Lincoln Foundation Award for Business Excellence and is invited to Chicago to receive award at a formal presentation with other winners. SAH is the first healthcare system to receive highest-level award.
SAH is notified by Modern Healthcare/HCIA that it was named a "Top 100" U.S. hospital.