HC4HR: Saving Lives Through Clinical Excellence

Today we'll share more of the innovative work being done by the Health CEOs for Health Reform by taking a look at Ascension Health’s Clinical Excellence initiative.

In 2003, Ascension Health, the nation’s largest nonprofit health care system, introduced a system-wide “Call To Action” to provide excellent clinical care. Committing to a transformational goal to provide “Healthcare that works, healthcare that is safe, and healthcare that leaves no one behind,” Ascension set out to eliminate all preventable injuries or deaths within five years -- by July 2008.

As Ascension Health President and CEO Anthony Tersigni describes in the video below, the results were nothing short of remarkable, far surpassing initial expectations.

Bringing together providers and other stakeholders from its nationwide healthcare network, Ascension identified eight "Priorities for Action" to improve quality and provide excellent clinical care. The primary metric its design team settled on was mortality reduction. Ascension estimated that, before it put its bold clinical transformation agenda into action, 15 percent of all deaths occurring in patients not admitted for end-of-life care were preventable -- corresponding to 900 lives throughout the Ascension network that could be saved each year.

Ascension also focused its quality improvement efforts on the Joint Commission National Patient Safety Goals, perinatal safety, serious falls, pressure ulcers (commonly known as bed sores), surgical complications, healthcare-associated infections, and adverse drug events.

To meet the goal of completely eliminating facility-acquired pressure ulcers, for instance, Ascension adopted a uniform scoring tool to assess a patient's risk. Its providers implemented a system-wide standardized plan of care called the SKIN bundle. SKIN stands for “Surface Selection,” which refers to having the appropriate bedding surface for patients, “Keep them Turning,” which involves patient mobility and positioning, “Incontinence Management,” and “Nutrition Support.” Ascension also began an ongoing education program regarding pressure ulcer elimination. (Pressure ulcers are not minor skin irritants. They can kill.)

Ascension Health’s quality improvement initiatives prevented more than 1500 deaths. The incidence of pressure ulcers dropped significantly  to a rate 95 percent lower than national estimates. Compared to national averages, the system experienced a reduction in birth trauma of 77 percent and a reduction in neonatal mortality of 81 percent. Ascension’s hospital readmission rate of 9 percent is half the national average.

As Tersigni explained in the video, Ascension Health’s success in improving outcomes and patient safety proves that rapid change is possible.

The ability of a system the size and scope of Ascension Health to reach such performance levels in providing healthcare that is safe in just five years is proof that rapid improvements in clinical quality of care, patient satisfaction, better and health, and efficient resource use are in fact possible.